About 80 percent of stroke survivors return to their homes after rehabilitation, according to previous research. It's 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 can worsen a stroke survivor's depression and negatively impact rehabilitation. Supporting caregivers may improve stroke rehabilitation and increase the likelihood that stroke survivors remain at home instead of going to nursing homes, researchers say.
This study by Alabama researchers examined "social problem-solving telephone partnerships"(SPTP) – a program in which nurses use 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., professor at the University of Alabama at Birmingham School of Nursing.
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 cover solving problems but obtained 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, then helped caregivers use effective problem-solving steps to manage caregiving problems during regular telephone calls.
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 score of 15.4 at baseline to mean score of 6.8 at the end of the intervention) 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.
The study was funded by in part by the National Institute of Nursing Research.
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