Stroke
Conditions
Keywords
Stroke, Executive Functions, Goal Management, Problem-Solving, Psychoeducation, Telerehabilitation
Brief summary
Many people have difficulties organising their behaviour and problem-solving (also known as executive function difficulties) after stroke. This can have serious, wide-ranging consequences for wellbeing and ability to regain independence. Currently, access to psychological interventions after stroke varies and there is not enough evidence to recommend a specific intervention for executive function difficulties after stroke. A short intervention was designed to help with executive function difficulties by making it easier to set goals and achieve them after stroke. The intervention is designed for online delivery to make it accessible to as many stroke survivors as possible. The present trial aims to investigate the acceptability and feasibility of a single blinded randomized controlled trial of this online executive function intervention (active intervention) compared to an online stroke psychoeducation intervention (control intervention).
Interventions
BEHAVIORALGetting things done after stroke
A two-session, online rehabilitation intervention focussing on cognitive executive functions supplemented with weekly homework tasks.
BEHAVIORALStroke psychoeducation
A two-session, online stroke psycho-education intervention supplemented with weekly homework tasks.
Sponsors
University of East Anglia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of stroke * ≥ 18 years of age * Capacitous consent to participate * Access to a computer / tablet, the internet, and an email address
Exclusion criteria
* Another significant mental or physical health condition * Current involvement in another research trial * Severe depression (over 20 on PHQ-9) * Not able to read or understand English * Visual, auditory or motor difficulties of a severity that limit the ability to attend to the content of the interventions, read the Participant Information Sheet or complete the consent form and outcome measures * Not registered with a GP or unwilling to provide GP information (for reporting suicidal ideation concerns
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Support to complete questionnaires | Through study completion, an average of 15 months. | Number of participants requiring support to complete questionnaires and time taken per participant |
| Recruitment Rate | Through study completion, approximately 15 months. | Rate of participants recruited into the trial amongst all participants screened |
| Exclusion Rate | Through study completion, an average of 15 months. | Rate of participants excluded from participating amongst all participants screened |
| Attrition Rate | Through study completion, an average of 15 months. | Rate of participants and data lost |
| Follow-up rate | Through study completion, an average of 15 months. | Rate of participants included at 1-month follow-up |
| Time required to collect and analyze data | Through study completion, an average of 15 months. | Time required for data collection per participant and final analysis |
| Questionnaire reminders | Through study completion, an average of 15 months. | Number of questionnaire reminders sent and time taken per participant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS, Tennant et al., 2007) | Baseline, post-intervention and at 1-month follow-up. | A 7-item questionnaire covering subjective wellbeing and psychological functioning. Respondents are asked to rate each of the items on a scale of 1 to 5 on the basis of how often they had experienced a symptom over the last 2 weeks (1=none of the time, 2=rarely, 3=some of the time, 4= often, 5=all of the time). |
| Revised Dysexecutive Questionnaire (DEX-R; Simblett, Ring & Bateman, 2016) | Baseline, post-intervention and at 1-month follow-up. | A tool for measuring everyday problems experienced with the dysexecutive syndrome. It consists of 37 items and respondents are asked to rate how often they experience difficulties related to executive functioning (0=never, 1=occasionally, 2=sometimes, 3=fairly often, 4=very often). |
| The Patient Health Questionnaire-9 (PHQ-9) | Screening | A self-report measure of depression consisting of nine items matching the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria of major depression. Respondents are asked to rate each of the items on a scale of 0 to 3 on the basis of how much a symptom has bothered them over the last 2 weeks (0=not at all, 1=several days, 2=more than half the days, 3=nearly every day). |
| The ICECAP-A (ICEpop CAPability measure for Adults; Al-Janabi, Flynn & Coast, 2012) | Baseline, post-intervention and at 1-month follow-up. | A measure of capability for the general adult (18+) population for use in economic evaluation. It comprises five attributes (attachment, stability, achievement, enjoyment, and autonomy). Each capability item has four levels of responses. |
| Feedback survey | Post-intervention. | A mixture of open-ended (free text response) and closed (Likert type response) questions to assess trial and intervention acceptability. |
| The stroke self-efficacy scale (SSES; Jones et al., 2008) | Baseline, post-intervention and at 1-month follow-up. | A 13-item measure of confidence for functional performance and aspects of self-management relevant post-stroke. Respondents are asked to rate their confidence that they can do various tasks that may have been difficult after having a stroke using a 4-point scale (0=not at all confident, 3=very confident). |
Countries
United Kingdom
Outcome results
None listed