Development of a Novel Positive Psychology-Based Intervention for Couples Post-Stroke

• Published in: Rehabilitation psychology 2018-02, Vol.63 (1), p.43-54
• Main Authors: Terrill, Alexandra L, Reblin, Maija, MacKenzie, Justin J, Cardell, Beth, Einerson, Jackie, Berg, Cynthia A, Majersik, Jennifer J, Richards, Lorie
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Caregivers; Caregivers - psychology; Cerebrovascular Accidents; Couples; Depressive Disorder - complications; Depressive Disorder - prevention & control; Depressive Disorder - psychology; Feasibility Studies; Female; Follow-Up Studies; Human; Humans; Intervention; Major Depression; Male; Middle Aged; Pilot Projects; Positive Psychology; Program Evaluation - methods; Spouses - psychology; Stroke - complications; Stroke - psychology; Stroke Rehabilitation - psychology; Survivors; Survivors - psychology; Symptoms; Treatment Compliance
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000181

Objective: Stroke provides challenges for survivors and partner caregivers. Stroke survivors and caregivers are interconnected in their emotional health, including depression, a common stroke sequelae. The purpose of this study was to develop and test the feasibility of a dyadic positive psychology-based intervention (PPI) for couples coping poststroke. Design: Community-dwelling couples consisted of 1 partner who had a stroke ≥6 months ago and a cohabiting partner caregiver. One or both partner(s) had to report depressive symptoms. The PPI consisted of 1 brief face-to-face training session and an 8-week self-administered intervention in which participants were instructed to engage in at least 2 activities alone and 2 together each week. Two dyads were randomly assigned to a waitlist control to test feasibility of this process. Baseline, postintervention, and 3-month follow-up assessments and post-program feedback were obtained. Descriptive statistics were used to analyze sample characteristics, recruitment and retention rates, adherence, key pre- and postintervention outcomes, and satisfaction with the intervention. Results: Eleven of 20 couples responding to recruitment letters were enrolled in the study. Ten of 11 dyads completed the program. All participants engaged in activities for at least 6 of 8 weeks. Feedback data indicated participant satisfaction with the intervention, and key outcome measures demonstrated adequate variability. Conclusions: The self-administered dyadic PPI is feasible for implementation with couples poststroke. The PPI represents a first step in a novel dyadic approach in this population. Recruitment, enrollment and attrition rates, and feedback will be used to inform a larger randomized trial. Impact and Implications There is a need for interventions targeting both survivor and caregiver depressive symptoms and well-being poststroke as current interventions are insufficiently effective. This study focuses on developing a dyadic positive psychology-based intervention targeting both stroke survivors and caregivers. The unique needs of caregivers are typically neglected by other dyadic approaches; yet sustaining well-being in caregivers is crucial so they can continue to provide care for their partner and also take care of themselves. Potential impact is significant as the positive psychology intervention (PPI) requires relatively few resources compared to traditional psychotherapy and can be adapted to reach geographically or si