Authors: Bragstad LK, Hjelle EG, Zucknick M, Sveen U, Thommessen B, Bronken BA, Martinsen R, Kitzmuller G, Mangset M, Kvigne KJ, Hilari K, Lightbody CE, Kirkevold M
Title: The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial
Source: Clinical Rehabilitation 2020 34(8): 1056–1071
Year: 2020
Research Design: Randomised Controlled Trial
Rating Score: 07/10
This rating is confirmed
Eligibility specified - Y
Random allocation - Y
Concealed allocation - Y
Baseline comparability - N
Blind subjects - N
Blind therapists - N
Blind assessors - Y
Adequate follow-up - Y
Intention-to-treat analysis - Y
Between-group comparisons - Y
Point estimates and variability - Y

OBJECTIVE: To evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at 12months post-stroke. DESIGN: Multicenter, prospective, randomized, assessor-blinded, controlled trial with two parallel groups. SETTING: Community. SUBJECTS: Three-hundred and twenty-two adults (18years) with stroke within the last four weeks were randomly allocated into intervention group (n=166) or control group (n=156). INTERVENTIONS: The intervention group received a dialogue-based intervention to promote psychosocial well-being, comprising eight individual 1-11/2hour sessions delivered during the first six months post-stroke. MAIN MEASURES: The primary outcome measure was the General Health Questionnaire-28 (GHQ-28). Secondary outcome measures included the Stroke and Aphasia Quality of Life Scale-39g, the Sense of Coherence scale, and the Yale Brown single-item questionnaire. RESULT(S): The mean (SD) age of the participants was 66.8 (12.1) years in the intervention group and 65.7 (13.3) years in the control group. At 12months post-stroke, the mean (SE) GHQ-28 score was 20.6 (0.84) in the intervention group and 19.9 (0.85) in the control group. There were no between-group differences in psychosocial well-being at 12months post-stroke (mean difference: -0.74, 95% confidence interval (CI): -3.08, 1.60). The secondary outcomes showed no statistically significant between-group difference in health-related quality of life, sense of coherence, or depression at 12months. CONCLUSION(S): The results of this trial did not demonstrate lower levels of emotional distress and anxiety or higher levels of health-related quality of life in the intervention group (dialogue-based intervention) as compared to the control group (usual care) at 12months post-stroke.

Access: Open Access