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Preventing Chronic Emotional Distress in Stroke Survivors and Their Informal Caregivers
Open accessAbstract
Background/objective Chronic emotional distress (e.g., depression, anxiety, post-traumatic stress) is common after stroke and interdependent between patients and their informal caregivers. We measured stroke survivors', caregivers', and neurocritical care nurses' views of primary drivers of distress during the stroke experience, and needs and preferences for the structure, topics, mode of delivery, and timing of an intervention to promote emotional recovery.Methods We conducted semi-structured interviews with 24 patient-caregiver dyads within the Neuroscience Intensive Care Unit (Neuro-ICU). Additionally, we conducted two focus groups with 15 nurses. Interviews and focus groups were audio-recorded, transcribed, and coded using NVivo 11 (QSR International) software.Results and conclusions The challenges and impacts of stroke most commonly reported by dyads were: uncertainty about future health, fear of recurrent strokes, negative emotions, and role changes post-stroke. Dyads and nurses agreed that resiliency skills such as mindfulness/focusing on the present, problem solving, gratitude/optimism, self-care, interpersonal communication and developing a supportive team of family, friends, and medical staff are beneficial to optimize recovery. The potential barrier to intervention delivery was accessibility, due to challenges of time and travel to appointments. Participants agreed that starting the intervention at hospitalization and continuing via live video after discharge is an ideal delivery modality. Stroke survivors, caregivers, and Neuro-ICU nurses believe that a resiliency skills-based intervention to prevent chronic emotional distress is necessary and urgent. This qualitative study provides valuable information on the challenges faced by dyads, intervention topics to prioritize, and strategies to maximize feasibility, acceptability, and effect.
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“Results suggest that the dyads were interested in learning MSBR techniques in the acute setting, but identified multiple challenges associated with continuing such practices postdischarge including the stress of intensive care days with adding in MSBR techniques.”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [64]
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“Present research studies are focused on either the informal caregiver or the stroke survivor; however, given the symbiotic nature of this relationship, it is suggested that the stroke survivor and informal caregiver be addressed as a dyad.4,9,64,65”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [64]
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“In a study that utilized neuroscience intensive care unit nurse focus groups as an adjunct to studying patient-caregiver dyads, nurses recognized that patients need MBIs to help catalyze their recovery, yet they did not feel they had adequate training to facilitate this process in the acute setting.64”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [64]
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“Nurses also suggested that an admission screening tool to help identify patients who could benefit most from MBI techniques would be useful.64”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [64]
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“There is compelling evidence for the interdependence of psychological health poststroke in both informal caregivers and stroke survivors.4,9,64”
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“Early symptoms of emotional distress in the acute period in both the stroke survivor and informal caregiver may evolve into chronic negative outcomes, including an increase in morbidity and mortality, for both groups.64”
From Nursing Implications of Mindfulness-Informed Interventions for Stroke Survivors and Their Families. (2022) · cites this paper as [64]
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Metadata
- Authors
- McCurley, J. L., Funes, C. J., Zale, E. L., Lin, A., Jacobo, M., Jacobs, J. M., Salgueiro, D., Tehan, T., Rosand, J., & Vranceanu, A.-M.
- Affiliations
- Harvard University (US)
- Corresponding author
- Vranceanu, Ana-Maria
- ORCID
- Venue
- Neurocritical Care
- Published
- 2018-11-12
- Volume
- 30
- Issue
- 3
- Pages
- 581-589
- ISSN
- 1541-6933 (ISSN-L)
- 1556-0961
- PMC
- PMC6958510
- OpenAlex
- W2901775239
- Cited by
- 171
- References
- 37
- Citations by year
- 2026: 22 · 2025: 42 · 2024: 24 · 2023: 27 · 2022: 29 · 2021: 12 · 2020: 11 · 2019: 4
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neurocritical Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association (228671)
- Brain Aneurysm Foundation (229663)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Keywords
- stroke, depression, anxiety, post-traumatic stress, informal caregivers, patient-caregiver dyads, resilience skills, mindfulness, self-care, emotional recovery
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Depression, Female, Humans, Intensive Care Units, Male, Middle Aged, Nursing Staff, Hospital, Stress Disorders, Post-Traumatic, Stress, Psychological, Caregivers, Focus Groups, Survivors, Stroke, Qualitative Research, Young Adult
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