Improving Quality of Life for Veterans with Stroke and Psychological Distress

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Stroke self-management treatment can improve disability, confidence in recovery, and quality of life. However, Veterans with comorbid stroke and psychological distress (anxiety and depression) have suboptimal mobility, little engagement in meaningful social interactions and poor quality of life. Effective management of psychological distress in patients with stroke is associated with positive physical functioning, social role functioning and quality of life. Current self-management treatments for Veterans with stroke inadequately address comorbid psychological distress. We propose to develop, refine, and pilot the Improving outcomes with comprehensive stroke self- management (I’m Whole) treatment. First, we will combine the Self-management TO Prevent Stroke using Video teleconferencing (VSTOP-II) and Enhancing Psychological Distress Coping (EPiC) cognitive-behavioral treatment to develop a single, group-based, behavioral stroke self- management treatment that addresses stroke risk reduction and psychological distress. Secondly, we will pilot test and refine the treatment. Lastly, we will test the feasibility and preliminary effectiveness of I’m Whole. We believe this proposal will provide a promising integrated treatment approach that will aid Veterans with comorbid psychological distress in living a functioning and fulfilling lifestyle.