Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke: A pilot randomized controlled trial

Tammy Hoffmann, Tamara Ownsworth, Sally Eames, David Shum

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)

Abstract

BACKGROUND: Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29%, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke.

METHODS: A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery andÅsberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor.

RESULTS: Thirty (91%) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences.

CONCLUSION: Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.

Original languageEnglish
Pages (from-to)116-126
Number of pages11
JournalTopics in Stroke Rehabilitation
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 2015

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Anxiety
Randomized Controlled Trials
Stroke
Depression
Psychological Adaptation
Self Care
Social Adjustment
Self Efficacy
Activities of Daily Living
Quality of Life
Outcome Assessment (Health Care)

Cite this

@article{7248174a139641918de2397a700190e4,
title = "Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke: A pilot randomized controlled trial",
abstract = "BACKGROUND: Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29{\%}, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke.METHODS: A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery and{\AA}sberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor.RESULTS: Thirty (91{\%}) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences.CONCLUSION: Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.",
author = "Tammy Hoffmann and Tamara Ownsworth and Sally Eames and David Shum",
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Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke : A pilot randomized controlled trial. / Hoffmann, Tammy; Ownsworth, Tamara; Eames, Sally; Shum, David.

In: Topics in Stroke Rehabilitation, Vol. 22, No. 2, 04.2015, p. 116-126.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke

T2 - A pilot randomized controlled trial

AU - Hoffmann, Tammy

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AU - Eames, Sally

AU - Shum, David

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N2 - BACKGROUND: Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29%, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke.METHODS: A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery andÅsberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor.RESULTS: Thirty (91%) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences.CONCLUSION: Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.

AB - BACKGROUND: Prevalence estimates for depression and anxiety in individuals post-stroke are approximately 33 and 29%, yet there are few effective preventive interventions. Interventions which commence pre-discharge and continue during the early post-discharge period may support individuals during the critical transition to home adjustment period. This study aimed to evaluate the efficacy of a self-management intervention and a coping skills intervention, compared to usual care, on anxiety and depression post-stroke.METHODS: A pilot, three-arm randomized trial involving 33 stroke patients (coping skills: n = 11, self-management: n = 12, usual care: n = 10) recruited from an Australian stroke unit. Both interventions were eight 1-hour weekly sessions, with the first two pre-discharge and the remainder at home; targeted both anxiety and depression; and tailored content to individuals. Primary outcome was severity of depressive and anxiety symptoms (measured using Montgomery andÅsberg Depression Rating Scale and Hospital Anxiety and Depression Scale). Secondary measures were: self-efficacy, stroke knowledge, basic and extended activities of daily living, and quality of life. Outcome measures were administered at baseline, one week post-intervention, and at a three month follow-up by a blinded assessor.RESULTS: Thirty (91%) participants completed the trial. Immediately post-intervention there was a small improvement in stroke knowledge and a small increase in depression symptoms (on one of the two measures of depression symptoms) in the coping skills group compared to usual care. These differences did not remain significant at the 3-month follow-up, nor were there any other significant differences.CONCLUSION: Neither a coping skills nor self-management intervention reduced anxiety nor depression symptoms early post-stroke more than usual care. Lack of statistical power may have contributed to the non-significant findings in this pilot study.

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DO - 10.1179/1074935714Z.0000000030

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JO - Topics in Stroke Rehabilitation

JF - Topics in Stroke Rehabilitation

SN - 1074-9357

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