The efficacy of problem solving therapy to reduce post stroke emotional distress in younger (18–65) stroke survivors

Introduction Occupational performance coaching modified for stroke survivors is a promising new intervention to improve occupational performance post stroke. In the intervention, following client-centred occupational goal-setting, clients are led through strengths-based problem-solving and experimentation. Emotional support, individualized education and goal-focused problem-solving are hypothesized as key elements. Examination of clients’ experiences is necessary to better understand how occupational performance coaching modified for stroke survivors works, and improve its potential effectiveness. Method A descriptive qualitative study was embedded in a pilot randomized controlled trial. Semi-structured interviews were completed with seven participants in the treatment arm who received occupational performance coaching modified for stroke survivors. Qualitative content analysis was used for analysis. Findings Three categories were identified related to participants’ experiences of occupational performance coaching modified for stroke survivors: (a) the coaching was helpful; (b) the coaching provided opportunity for insightful reflection and (c) a different approach was preferred. Findings also lend support to the critical role of hypothesized key components and theorized mechanisms of action, and demonstrate the overarching role of the therapeutic relationship and the contribution of personal characteristics. Conclusion The revised theoretical understanding of occupational performance coaching modified for stroke survivors provides a valuable framework for communicating the actions that occupational therapists take in enabling occupation and emphasizes the role of the therapeutic relationship in client-centred approaches to improving occupational performance post stroke.

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Caring for family caregivers: An analysis of a family-centered intervention

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420140000600013 ◽

2014 ◽

Vol 48 (spe) ◽

pp. 87-94 ◽

Cited By ~ 6

Author(s):

Carme Ferré-Grau ◽

Maria Sevilla Casado ◽

Dolors Cid-Buera ◽

Mar LLeixà-Fortuño ◽

Pilar Monteso-Curto ◽

...

Keyword(s):

Problem Solving ◽

Family Caregivers ◽

Emotional Distress ◽

Care Service ◽

Care Center ◽

Intervention Group ◽

Problem Solving Therapy ◽

Health Care Center ◽

Mixed Analysis ◽

Anxiety Depression

Objective To assess the effectiveness of Problem-Solving Therapy (PST) on family caregivers through the use of scales to measure anxiety, depression and emotional distress; and to explore facilitating factors and obstacles for its use based on the narrative of nurses. Method A clinical trial and an exploratory focus group with the use of mixed analysis methodology. The study was conducted in a primary health care center in Tarragona, Spain, and the sample consisted of 122 family caregivers who were included in the home care service, and 10 nurses who participated in the intervention group. Family caregivers with evident symptoms of anxiety, depression and emotional distress received PST in the intervention group. The intervention group also consisted of a discussion with eight nurses, which was transcribed and submitted to content analysis. Conclusion Problem-Solving Therapy proved to be effective in reducing perceived anxiety, depression and emotional distress. We identified its strong points and obstacles as described by nurses.  

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