Interventions for Caregivers of People Who Have Had a Stroke: A Systematic Review. 2023

Amanda Mack, and Mary Hildebrand
Amanda Mack, OTD, MS, OTR/L, CLC, is Assistant Professor and Director of Post-Professional Education, Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO; macka@wustl.edu. At the time this research was completed, Mack was Instructor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Charlestown, MA.

OBJECTIVE It is vital that occupational therapy practitioners address caregivers' needs to enable them to maintain participation in caregiving for people poststroke. OBJECTIVE To explore the evidence for the effectiveness of interventions within the scope of occupational therapy practice for caregivers of people poststroke that facilitate maintaining participation in the caregiver role. METHODS We conducted a narrative synthesis systematic review of the literature published in the MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases between January 1, 1999, and December 31, 2019. Article reference lists were also hand searched. METHODS The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines were used, and articles were included if they were within the date range and scope of occupational therapy practice and included caregivers of someone poststroke. Two independent reviewers used Cochrane methodology to perform the systematic review. RESULTS Twenty-nine studies met the inclusion criteria and were divided into five intervention themes: cognitive-behavioral therapy (CBT) techniques, caregiver education only, caregiver support only, caregiver education and support, and multimodal interventions. Both the CBT technique of problem-solving combined with stroke education and one-on-one caregiver education and support interventions had strong strength of evidence. Multimodal interventions had moderate strength of evidence, and caregiver education only and caregiver support only had low strength of evidence. CONCLUSIONS Addressing caregiver needs with problem-solving and caregiver support in addition to typical education and training is essential. More research is needed that uses consistent doses, interventions, treatment settings, and outcomes. What This Article Adds: Although more research is needed, occupational therapy practitioners should provide combinations of interventions such as problem-solving techniques, customized support for each caregiver, and individualized education in the care of the stroke survivor.

UI MeSH Term Description Entries
D009788 Occupational Therapy Skilled treatment that helps individuals achieve independence in all facets of their lives. It assists in the development of skills needed for independent living. Ergotherapy,Therapy, Occupational,Ergotherapies,Occupational Therapies,Therapies, Occupational
D004522 Educational Status Educational attainment or level of education of an individual. Education Level,Educational Achievement,Educational Attainment,Educational Level,Level of Education,Maternal Education Level,Maternal Educational Attainment,Maternal Educational Level,Paternal Education Level,Paternal Educational Attainment,Paternal Educational Level,Achievement, Educational,Educational Status, Maternal,Educational Status, Paternal,Maternal Educational Status,Paternal Educational Status,Status, Educational,Attainment, Educational,Attainment, Maternal Educational,Attainment, Paternal Educational,Education Level, Maternal,Education Level, Paternal,Education Levels,Educational Achievements,Educational Attainment, Maternal,Educational Attainment, Paternal,Educational Attainments,Educational Level, Maternal,Educational Level, Paternal,Educational Levels,Level, Education,Level, Educational,Level, Maternal Education,Level, Maternal Educational,Level, Paternal Education,Level, Paternal Educational,Levels, Maternal Educational,Maternal Education Levels,Maternal Educational Attainments,Maternal Educational Levels,Paternal Education Levels,Paternal Educational Attainments,Paternal Educational Levels,Status, Maternal Educational,Status, Paternal Educational
D006266 Health Education Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. Community Health Education,Education, Health,Education, Community Health,Health Education, Community
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017028 Caregivers Persons who provide care to those who need supervision or assistance in illness or disability. They may provide the care in the home, in a hospital, or in an institution. Although caregivers include trained medical, nursing, and other health personnel, the concept also refers to parents, spouses, or other family members, friends, members of the clergy, teachers, social workers, fellow patients. Family Caregivers,Informal Caregivers,Spouse Caregivers,Care Givers,Carers,Care Giver,Caregiver,Caregiver, Family,Caregiver, Informal,Caregiver, Spouse,Caregivers, Family,Caregivers, Informal,Caregivers, Spouse,Carer,Family Caregiver,Informal Caregiver,Spouse Caregiver
D020521 Stroke A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810) Apoplexy,Cerebral Stroke,Cerebrovascular Accident,Cerebrovascular Apoplexy,Vascular Accident, Brain,CVA (Cerebrovascular Accident),Cerebrovascular Accident, Acute,Cerebrovascular Stroke,Stroke, Acute,Acute Cerebrovascular Accident,Acute Cerebrovascular Accidents,Acute Stroke,Acute Strokes,Apoplexy, Cerebrovascular,Brain Vascular Accident,Brain Vascular Accidents,CVAs (Cerebrovascular Accident),Cerebral Strokes,Cerebrovascular Accidents,Cerebrovascular Accidents, Acute,Cerebrovascular Strokes,Stroke, Cerebral,Stroke, Cerebrovascular,Strokes,Strokes, Acute,Strokes, Cerebral,Strokes, Cerebrovascular,Vascular Accidents, Brain

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