The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial

• Published in: Clinical Rehabilitation
• Main Authors: Bragstad, Line Kildal, Hjelle, Ellen Gabrielsen, Zucknick, Manuela, Sveen, Unni, Thommessen, Bente, Bronken, Berit Arnesveen, Martinsen, Randi, Kitzmüller, Gabriele, Mangset, Margrete, Kvigne, Kari Johanne, Hilari, Katerina, Lightbody, C. Elizabeth, Kirkevold, Marit
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 2020
• Subjects: Strokes; Rehabilitations; Randomized controlled trials; Coherence senses; Psychosocial support systems; Arctic; Narvik; Norway; Arctic University of Norway; UiT The Arctic University of Norway
• Online Access: https://hdl.handle.net/10642/8833; https://doi.org/10.1177/0269215520929737

Objective: To evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at 12 months post-stroke. Design: Multicenter, prospective, randomized, assessor-blinded, controlled trial with two parallel groups. Setting: Community. Subjects: Three-hundred and twenty-two adults (⩾18 years) 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 1–1½ hour 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. Results: 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 12 months 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 12 months 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 12 months. Conclusion: 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 12 months post-stroke. The following financial support was granted for the research, authorship, and/or publication of this article: the European Union Seventh Framework Program (FP7-PEOPLE-2013-COFUND; Grant Agreement No. 609020—Scientia Fellows); the South-Eastern Norway Regional Health Authority (Project no. 2013086); and the Extra Foundation (Grant No. 2015/FO13753). The University of Oslo, Oslo University Hospital, the Inland Norway University of Applied Sciences, and UiT, the Arctic University of Norway, Narvik have provided research time, administrative and organizational support, and additional funding for the study. publishedVersion