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Stress in caregivers of aphasic stroke patients: a randomized controlled trial

Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney and Department of Psychiatry and School of Public Health & Community Medicine, University Of New South Wales, Sydney, Australia, b.draper{at}unsw.edu.au

Greg Bowring

Department of Rehabilitation Medicine, St George Hospital, Sydney and School of Public Health & Community Medicine, University Of New South Wales, Sydney, Australia

Claire Thompson

Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney and Department of Psychiatry, University Of New South Wales, Sydney, Australia

Jocelyn Van Heyst

Department of Rehabilitation Medicine, St George Hospital, Sydney, Australia

Philip Conroy

School of Public Health & Community Medicine, University Of New South Wales, Sydney and Rehabilitation Department, Sutherland Hospital, Sydney, Australia

Julie Thompson

Department of Rehabilitation Medicine, St George Hospital, Sydney, Australia

Background: Communication difficulties due to aphasia following stroke are particularly stressful to caregivers.

Objective: To examine the impact of a psychoeducation programme on caregivers’ burden and stress and communication between the caregiver and aphasic stroke patient.

Design: Randomized wait-list controlled trial with immediate or three-month delayed treatment.

Setting: Three public hospital rehabilitation services in Sydney, Australia.

Subjects: Thirty-nine caregivers of aphasic stroke patients, up to 12 months post stroke: 19 given immediate treatment and 20 in a delayed treatment control group.

Interventions: Four-session weekly caregiver programme that included elements of education, support and communication skills conducted by a speech pathologist, social worker and clinical psychologist.

Main measures: The General Health Questionnaire (GHQ) was used to measure caregiver stress, the Relatives’ Stress Scale was used to measure caregiver burden and a communication questionnaire was designed specifically for this project.

Results: Thirty-one caregivers completed the study. Caregivers in the immediate treatment group had significant reductions in GHQ measured stress (GHQ mean (SD) at baseline= 6.26 (5.67), GHQ post treatment 3.21 (SD 4.20), P = 0.006). There was no improvement in wait-listed caregivers. Improvement was not maintained at three-month follow-up. There were no significant effects of the programme on communication skills or on caregiver burden.

Conclusions: Stroke caregiver support, education and training programmes have short-term effects on caregiver stress levels but are likely to require ongoing involvement to maintain their effect.

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