Multiple Disability, Physical Disability, Stroke
Conditions
Keywords
Activities of daily living, Caregiver burden, Client centered, Life satisfaction, Participation, Patient satisfaction, Rehabilitation, Self rated impact of stroke, Stroke
Brief summary
This is a cluster randomized controlled trial in which client-centered rehabilitation of activities of daily living (CADL) will be compared to usual rehabilitation of activities of daily living (UADL) regarding participation in activities of daily living, independence in activities of daily living and life satisfaction during the first year after stroke. In addition use of health services, caregiver burden and significant others' life satisfaction will be studied. Study design, methods and power analysis are based on our previous pilot study. Participating rehabilitation centers in the counties of Stockholm, Uppsala and Gavleborg have been randomized to supply CADL or UADL. Patients are included who are: \< 3 months after stroke, dependent in at least two activities of daily living, understand instructions and referred to a participating rehabilitation unit. Data are collected at baseline, 3, 6 and 12 months. For sufficient power 280 participants will be included. In addition qualitative longitudinal studies will be performed in order to describe how CADL is integrated.
Interventions
BEHAVIORALClient-centered ADL intervention
Client-centered ADL refers to rehabilitation of activities of daily living specifically guided by the needs as expressed by the client/patient and her/his significant others, a process that specifically aims to support the client by taking the client's goals and views as the guide for the rehabilitation process.
BEHAVIORALUsual ADL intervention
The variation of strategies and ways to conduct usual ADL rehabilitation according to the routines and praxis of the participating rehabilitation units randomized to supply the control condition.
Sponsors
The Swedish Research Council
Swedish Council for Working Life and Social Research
The Swedish Brain Foundation (Hjärnfonden)
Stroke-Riksförbundet
Region Stockholm
Uppsala County Council, Sweden
Uppsala-Örebro Regional Research Council
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* \< 3 months after stroke * Dependent in at least two activities of daily living * Able to understand instructions * Referred to a participating rehabilitation unit.
Exclusion criteria
* Diagnosed dementia
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Perceived participation | 12 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Life satisfaction | 3 and 12 months | — |
| Utilization of health care and health related services | During one year after inclusion | — |
| Fatigue | baseline, 3, 6 and 12 months | — |
| Caregiver burden | 3 and 12 months | — |
| Self rated impact of stroke | 3, 6 and 12 months | Stroke Impact Scale |
| Activities of daily living | baseline, 3, 6 and 12 months | — |
| Satisfaction with care | 3, 6 and 12 months | — |
Countries
Sweden
Outcome results
None listed