title: A cluster randomized controlled trial of a structured training programme for caregivers of inpatients after stroke (TRACS).
abstract: BACKGROUND
  The majority of stroke patients are discharged home dependent on informal caregivers, usually family members, to provide assistance with activities of daily living, including bathing, dressing, and toileting. Many caregivers feel unprepared for this role, and this may have a detrimental effect on both the patient and caregiver.
  
  
  OBJECTIVE
  To evaluate whether a structured, competency-based training programme for caregivers improves physical and psychological outcomes for patients and their caregivers after disabling stroke, and to determine if such a training programme is cost-effective.
  
  
  METHODS
  A cluster randomized controlled trial. The trial aims to recruit 25 patient and caregiver dyads from each of the 36 participating stroke rehabilitation units. Stroke units have been randomized to either the intervention or control group with randomization stratified by geographical region and quality of care. The intervention is the London Stroke Carer Training Course developed and evaluated in a previous single-centre study. The London Stroke Carer Training Course comprises a number of caregiver training sessions and competency assessment delivered while the patient is in the hospital and one follow-up session after discharge. The multidisciplinary teams in the units randomized to the intervention group have been trained to incorporate delivery of the London Stroke Carer Training Course into ward practice, while those randomized to the control group have continued to provide usual care according to national guidelines.
  
  
  RESULTS
  The primary outcomes are extended activities of daily living for the patient and caregiver burden measured at six-months after recruitment. Secondary outcomes include mood and cost-effectiveness, with final follow-up at 12 months.
authors: Academic Unit of Elderly Care and Rehabilitation, University of Leeds and Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. a.forster@leeds.ac.uk
authors: Anne
authors: A
authors: Forster
authors: John
authors: J
authors: Young
authors: Jane
authors: J
authors: Nixon
authors: Lalit
authors: L
authors: Kalra
authors: David
authors: D
authors: Smithard
authors: Anita
authors: A
authors: Patel
authors: Martin
authors: M
authors: Knapp
authors: Josie
authors: J
authors: Monaghan
authors: Rachel
authors: R
authors: Breen
authors: Shamaila
authors: S
authors: Anwar
authors: Amanda
authors: A
authors: Farrin
mesh_terms: D017028:Caregivers / Q000193:education*; D006801:Humans; D020127:Recovery of Function; D012107:Research Design; D000071939:Stroke Rehabilitation