Psychosocial interventions for carers of survivors of stroke: a systematic review of interventions based on psychological principles and theoretical frameworks.
OBJECTIVE
Most stroke survivors are cared for at home by informal carers, usually their partners or children. The chronic burden of meeting these care needs can have a significant impact on the psychological well-being of the carer. The aim of this review is to analyse interventions that target psychosocial functioning in carers of stroke survivors to understand how such interventions can reduce the burden of caring.


METHODS
Seven studies that reported on randomized controlled trials of psychosocial interventions for informal adult carers of a survivor of stroke, which reported validated measures of psychological health outcome and met a satisfactory rating of quality were included in this systematic review.


RESULTS
A forest plot of two studies that used education and counselling as the intervention for patients and spouses indicate a more favourable outcome for the intervention on the global family functioning scale. The Clarke, Rubenach, and Winsor (2003) study showed that patients were more likely to benefit from an intervention consisting of counselling and education than spouses.


CONCLUSIONS
It is noted that there are relatively few studies investigating the impact of psychologically based interventions for carers of stroke survivors and the quality of evidence is varied. However, there is evidence of good quality to show that stroke patients benefit from a counselling combined with education intervention. The clinical implications of this review suggests, according to current available evidence, that those working with survivors of stroke and their families should consider providing counselling and education interventions to patients in the first instance. More research is needed to determine the effectiveness of interventions aimed at improving the psychosocial functioning of carers of survivors of stroke.
Eldred
Clare
C
London Brain Injury Centre, Rehab UK, London, UK. clareeldred@rehabuk.org
Sykes
Catherine
C
D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D011582:Psychological Theory; D011584:Psychology; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate