The effects of introducing psychoeducational programs in patients with stroke in post-acute care

Česká verzia

Authors: E. Prušová ¹; D. Školoudík ²; K. Langová ¹; K. Procházková ³; H. Kisvetrová ¹
Authors place of work: Centrum vědy a výzkumu, Fakulta zdravotnických věd, UP, Olomouc ¹; Centrum zdravotnického výzkumu, LF OU, Ostrava ²; Oddělení klinické psychologie, Neurochirurgická klinika FN Brno ³
Published in the journal: Cesk Slov Neurol N 2023; 86(6): 383-390
Category: Původní práce
doi: https://doi.org/10.48095/cccsnn2023383

Summary

Background: Stroke is not only a very common cause of death, but also the most common cause of disability and long-term health problems with a significant impact on patients‘ quality of life. The present study aimed to assess the effects of a psychoeducational program delivered simultaneously with standard rehabilitation care to patients in the post-acute phase of stroke on their health-related quality of life (HRQoL), dignity, levels of depression, levels of self-sufficiency in activities of daily life, and also pain. Methods: The randomized study involved adult patients after their first stroke occurrence who were admitted to post-acute inpatient rehabilitation care due to persistent neurological deficits. At the same time, they were partially self-sufficient and did not present with dementia or a phatic disorder or severe visual or hearing impairment. In addition to standard care, the intervention group was provided with multi-component psychoeducation. Data collection took place at patient enrollment and 3 months later using standardized questionnaires for health-related quality of life (EQ-5D-5L), depression (Beck‘s Depression Inventory [BDI-II]), dignity (The Patient Dignity Inventory [PDI]), coping with activities of daily living (Barthel index [BI]) and pain (Visual Analogue Scale [VAS]). Statistical evaluation was performed using univariate and multivariate analyses. Results: Of the 221 randomized patients, 201 (91%) completed the study; 102 in the intervention group (65 men, age 60 ± 13.6 years) and 99 in the control group (58 men, age 63 ± 13.4 years). After 3 months, there was a statistically significant difference in the change in EQ-5D-5L/domains (2.77 ± 2.08 vs. 0.93 ± 1,81), EQ-VAS (13.77 ± 12.06 vs. 4.23 ± 15.51), PDI (9.50 ± 8.33 vs. 2.47 ± 8.18), BI (14.94 ± 11.02 vs. 8.96 ± 9.16) and BDI (3.15 ± 3.61 vs. 0.40 ± 4.19) in the intervention group compared to the control group (for all P < 0.0001). Post-hoc analysis showed that the independent predictors of higher HRQoL were, apart from applied psychoeducation, greater degrees of self-sufficiency, less severe depression levels and lower intensity of pain. Conclusion: Psychoeducation is a suitable supplement to post-acute rehabilitation care for post-stroke patients leading to improvements in HRQoL, greater independence in activities of daily life, reduction of depression load and increased sense of dignity.

Keywords:

stroke – depression – health-related quality of life – dignity – psychoeducation – self-suffi ciency

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