The stroke it is one of the leading causes of death and disability in the world in the adult population. Because it happens suddenly, its effects on people's lives and psychosocial well-being are often devastating. We can define the psychosocial well-being as a state of satisfaction, a self-concept characterized by self-acceptance, a sense of usefulness and confidence in one's abilities. This network of social factors, thoughts and behaviors is unfortunately affected by the events following the stroke, turning into anxiety and depression.

According to estimates, about one third of stroke survivors report depressive symptoms, and 20% report post-stroke anxiety. The prevalence of post-stroke depression remains high, persisting even 5 years after the event. Psychosocial difficulties have a significant impact on quality of life and reduce the effectiveness of rehabilitation services.

Anciently, it was believed that targeted treatments can improve the psychosocial abilities post-stroke but the inconclusive evidences lead to the failure of this theory. Then in XNUMX, Line Kildal and Ellen et al proposed a presumption that a dialogue-based intervention can be used to promote the psychosocial well being after stroke and conducted the following research under discussion. Recently, their work is published in Clinical Rehabilitation Journal.

The aim was to evaluate the effectiveness of the treatment on the psychosocial well-being of subjects 12 months after the stroke. For the study they were selected 322 adults with recent stroke (4 weeks), randomly assigned to the experimental and control group. The experimental group participated in eight individual 60-90 minute sessions in the first six months of the stroke.



I results of this research showed no differences in the psychosocial well-being of the subjects in the two groups at 12 months. As regards the effects on the quality of life, an improvement was found during the operation which, however, was not maintained 12 months after the stroke.

In short, it is concluded that this study did not demonstrate lower levels of emotional distress and anxiety or higher levels of health-related quality of life in the intervention group (given dialogue-based intervention) as compared to the control group at 12 months post-stroke. Also, there is insufficient evidence to support the implementation of the intervention in the current form based on the outcome measures used in this trial.

The results of this study suggest that in the future, more research is needed to explore the relationships between psychosocial well-being, sense of coherence, and the process of meaning-making and adjustment following an acute stroke. Furthermore, using more adequate instruments in exploring these relationships will help in measuring the effectiveness of the dialogue-based intervention in psychosocial well-being more accurately.

Antonio Milanese (SLP)
Speech therapist and computer programmer with a particular interest in learning. I made several apps and web-apps and taught courses on the relationship between speech therapy and new technologies.

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