Stroke is one of the leading causes of death and disability in the adult population worldwide. It leads to have devastating effects on people’s life and threatening their psychosocial well-being too. Psychosocial well-being can be defined as consisting of a basic mood of contentment, a self-concept characterized by self-acceptance, usefulness, and a belief in one’s abilities. This interrelation of social factors and thoughts or behavior of individuals is greatly influenced by the stroke, leading to depression and anxiety.
According to an estimation, about one-third of stroke survivors report depressive symptoms, and XNUMX% report post-stroke anxiety. The prevalence of post-stroke depression remains high i.e XNUMX to XNUMX years post-stroke and psychosocial problems persist over time. Psychosocial difficulties significantly impact the quality of life and reduce the effects 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 objective behind this study was to evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at XNUMX months post-stroke. To achieve this aim, the authors carried out a controlled, randomized trial with two groups i.e control and intervention group in a community setting.
Subjects selection was completed by selecting XNUMX adults (⩾XNUMX years) with stroke within the last four weeks and randomly allocated them into the intervention group and control group in XNUMX:XNUMX. The sample size for the trial was determined by the General Healthcare Questionnaire-XNUMX (GHQ-XNUMX) based on the primary outcome of the research.
The intervention group received a dialogue-based intervention to promote psychosocial well-being, comprising eight individual 1–1½ hour sessions delivered during the first six months post-stroke.
The data from both the groups were collected by interviewing the participants by trained healthcare professionals at a period of 4-6 weeks post-stroke, 6 months, and 12 months post-stroke. The intervention was delivered in a community setting. All the data collected were analyzed using the Statistical Package for Social Sciences (SPSS) and all the tests were performed as two-sided tests (significance level = 0.05).
SPSS: a software package used for interactive, or batched, statistical analysis of social sciences data.
The results of this research indicated that there were no between-group differences in psychosocial well being at 12 months post-stroke. Talking about the effects on the quality of life of participants, it was improved during the course but there was no satisfactorily significant difference between the intervention and control group at 12 months post-stroke. There was no demonstration of higher levels of psychosocial well-being followed by a lower level of anxiety in the intervention group compared to the control group. However, it is assumed that the intervention can support the participants’ perceptions of their lives as more comprehensible, manageable, and meaningful. The reduction or increase in the anxiety level in participants depends on the existing stress level, having an impact on their quality of life and coherence level. The results supported that psychosocial well-being is also associated with higher levels of coherence.
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.