The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors: a systematic review and meta-analysis.
OBJECTIVE
To evaluate the effectiveness of psychosocial interventions for family caregivers on their psychosocial and physical wellbeing, quality of life, and the use of healthcare resources by stroke survivors.


METHODS
Electronic English and Chinese bibliographic databases were searched (inception to January 2012) for clinical trials. Two reviewers independently selected and appraised study quality. When possible, data from randomized controlled trials (RCTs) were statistically pooled. Otherwise, a narrative summary was used.


RESULTS
Eighteen studies (psychoeducation and social support group) were included. Pooled analysis of two individual psychoeducation programs showed a small effect on improving family functioning (SMD: -0.12; 95% CI: -0.23 to -0.01; p=0.03). Caregivers receiving psychoeducation that aimed at equipping caregivers with the skills of problem-solving, caregiving, and stress-coping appeared to have a more positive influence on the caregivers' psychosocial wellbeing and a reduced use of healthcare resources by stroke survivors.


CONCLUSIONS
Evidence on the effects of psychosocial interventions was limited. More RCTs of multifaceted psychoeducation programs are needed to further examine the optimal dose and format.


CONCLUSIONS
To support caregivers across the stroke trajectory, the core skills of problem-solving and stress-coping should be included in the psychosocial interventions.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region. Electronic address: hycheng@cuhk.edu.hk.
Ho Yu
HY
Cheng
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Sek Ying
SY
Chair
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Janita Pak-Chun
JP
Chau
D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D011340:Problem Solving; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D020377:Self Efficacy; D012944:Social Support; D013315:Stress, Psychological; D020521:Stroke / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
Family caregivers; Meta-analysis; Physical health; Psychosocial interventions; Psychosocial wellbeing; Quality of life; Stroke; Systematic review