Psychosocial interventions for stroke survivors, carers and survivor-carer dyads: a systematic review and meta-analysis

ABSTRACT

Objective: To evaluate the effectiveness of psychosocial interventions on depressive symptoms, anxiety symptoms, quality of life, self-efficacy, coping, carer strain and carer satisfaction among stroke survivors, carers and survivor-carer dyads.

Data sources: MEDLINE, CINAHL, PsycINFO, SocINDEX, Cochrane Library, Web of Science and Scopus databases and the grey literature were searched up to September 2018.

Methods: A systematic review and meta-analysis of randomized controlled trials of psychosocial interventions for stroke survivors, carers and survivor-carer dyads, compared to usual care. Outcomes measured were depressive symptoms, anxiety symptoms, quality of life, coping, self-efficacy, carer strain, and carer satisfaction.

Results: Thirty-one randomized controlled trials (n = 5715) were included in the systematic review which found improvements in depressive symptoms, anxiety symptoms, quality of life and coping, though the number of trials assessing each outcome varied. A meta-analysis (11 trials; n = 1280) on depressive symptoms found that in seven trials psychosocial interventions reduced depressive symptoms in stroke survivors (SMD: −0.36, 95% CI −0.73 to 0.00; p = .05) and in six trials reduced depressive symptoms in carers (SMD: −0.20, 95% CI −.40 to 0.00; p = .05).

Conclusion: Psychosocial interventions reduced depressive symptoms in stroke survivors and their carers. There was limited evidence that such interventions reduced anxiety symptoms, or improved quality of life and coping for stroke survivors and carers and no evidence that they improved self-efficacy, carer strain or carer satisfaction.

KEYWORDS:

• Psychosocial
• stroke
• survivors
• carers
• systematic review
• meta-analysis

Declaration of interests

The authors declare no potential conflicts of interest with respect to the research, the authorship, and/or publication of this article.

Supplementary material

Supplemental data for this article can be accessed here.

Clinical trial registration

Systematic review registration: CRD42017071129 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=71129

Correction Statement

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Additional information

Funding

Supported by the Australian Government’s Collaborative Research Networks (CRN). .