Mental-health support by telephone shows promise both for caregivers
adjusting to their new roles and for stroke survivors recently released
from the hospital, according to an article in the August issue of
Stroke.
About 80 percent of American stroke survivors return to their homes
after rehabilitation, according to previous research. It is often
difficult for family members to adapt to their new roles as caregivers
charged with managing the physical, cognitive, emotional, and personality
changes associated with stroke. Research has shown that caregiver
depression is not only a burden for the caregiver but it can also
worsen a stroke survivor’s depression and rehabilitation. The researchers
hypothesized that adequate supports might benefit both caregivers
and patients, resulting in better household mental health and in
improved likelihood that the stroke survivor can remain at home.
The current study examined social problem-solving telephone partnerships
? a program in which nurses used the telephone to help family caregivers
resolve challenges of caring for stroke survivors. Previous studies
have examined social problem?solving therapy using face-to-face
contacts with individuals or groups.
“The telephone may be a cost-effective method that nurses and other
health professionals may use to assist family members to feel good
about themselves, to solve problems optimistically, and to use a
systematic and objective method to manage caregiving problems,”
says lead author Joan S. Grant, D.S.N., R.N.
The American researchers divided 74 primary caregivers into three
groups. One received the problem-solving assistance phone conversations
(intervention). Another group got phone calls that did not have
the goal of solving problems but instead gave information about
health care services received by the stroke survivor (sham intervention).
The third group got no phone calls (control group). In the phone
intervention, nurses conducted an initial three-hour home visit
before making regular telephone calls to help caregivers use effective
problem-solving steps to manage caregiving problems.
Over four weeks, those in the intervention group improved significantly
in how they viewed caregiving problems. They improved an average
56 percent in depression (decrease from a mean baseline score of
15.4 to a mean final score of 6.8) and 50 percent in negative problem
orientation (from 12.2 to 6.1). Participants also improved in emotional
well-being, mental health, and vitality.
Telephone sessions may be effective because they identify and address
the unique concerns and issues of individual caregivers, Grant says,
and the support technique may be applicable to other situations
involving patients with chronic disease or disability who are being
cared for at home.