Biopsychosocial intervention for stroke carers (BISC): Results of a feasibility randomised controlled trial

Abstract

Background and Aims: We developed an intervention for carers of stroke survivors which combined education about the biological, psychological and social effects of stroke with strategies and techniques focussing on adjustment to stroke. Our aim was to determine whether it was feasible to deliver the intervention in a randomised controlled trial. Method: Carers of stroke survivors were randomised to intervention or usual care control. The intervention was delivered by a research psychologist in groups of up to five carers, or one-to-one for those unable to attend groups. It was structured in two-hour sessions over six consecutive weeks. Outcomes at six months included: health-related quality of life (EQ5D-5L); anxiety and depression (HADS); carer burden (Caregiver Burden Scale). Results: 257 carers were approached and 41 consented at a median of 65 days post-stroke. 14/18 intervention participants agreed to attend the groups and four on a one-to-one basis. Participants attended a mean of 3.4(2.0) group and 5.8(0.5) one-to-one sessions. Thirty participants were followed-up. There were improvements from baseline on all outcome measures in both the intervention and control groups. Conclusion: There were recruitment difficulties with carers stating they were too busy to take part, reporting that they had needed psychological support earlier, or that they did not need the intervention. It was possible to deliver the intervention in a group format although attendance was low due to carers' other commitments. Attendance at one-to-one sessions was higher. Conclusion: Further exploratory and feasibility work is needed to identify the optimum timing for recruitment and the format for intervention delivery.