Testing efficacy of an intervention to promote Resilience in Stroke survivor-carepartner Dyads (ReStoreD)

项目摘要/摘要 中风的影响由中风幸存者和他们的配偶/伴侣照顾者(照顾者)分担。 据估计，30%-50%的中风幸存者和照顾者经历了抑郁或焦虑的症状 对康复结果和生活质量产生负面影响。然而，支持中风后夫妇的干预措施 在很大程度上是不够的或无法访问的。为了满足这一需求，我们开发了一种新型的远程递送二元组 干预以提高卒中幸存者-照顾者伴侣DYADS的复原力(恢复)，夫妇在其中学习 并练习设定目标、交流策略和积极心理学活动，如表达 感恩，寻找意义，培养联系。初步的初步研究结果是有希望的，显示出 减少了参与者的抑郁症状，提高了复原力。当前研究的目的是 进行为期8周的恢复性干预的第二阶段疗效试验，样本为200对(n=400) 由一名在3个月至3个月之间经历过缺血性或出血性中风的人组成 入学前数年和同居照料者。使用全功能、随机的等待列表控制 设计，我们将确定恢复的有效性，以减少双方成员的情绪困扰(目标1)。 我们还将研究恢复对次要结果的影响(弹性、关系质量、压力- 相关中风，有意义的活动参与)作为潜在的调解人(目标2)，并探索主持人以 确定某些小组对干预的反应是否更好(目标3)。所有参与者都将完成 在基线、8周、16周和6个月的随访中进行标准化的有效评估。的方方面面 研究，包括干预活动和评估，远程、在线进行。 这是第一个严格设计的有效性试验，以测试对中风幸存者的积极心理干预。 和他们的护理伙伴。当这项研究的目标实现时，我们将有1)远程交付的、二元的 干预以支持夫妇中风后；2)更好地了解中风后 干预对情绪困扰的影响，并可以利用这些信息为未来的干预提供信息；以及3) 能够确定干预最有效的更具体的目标人群。最终，如果找到 这种干预是有效的，将为那些正在应对 中风，以改善康复结果和生活质量。

PROJECT SUMMARY/ABSTRACT The impact of stroke is shared between the stroke survivor and their spousal/partner caregiver (carepartner). An estimated 30-50% of stroke survivors and carepartners experience depressive or anxiety symptoms that negatively affect rehabilitation outcomes and quality of life. Yet, interventions to support couples post-stroke are largely insufficient or inaccessible. To address this need, we developed a novel remotely-delivered dyadic intervention to promote Resilience in Stroke survivor-carepartner Dyads (ReStoreD), in which couples learn and practice goal-setting, communication strategies, and positive psychology activities like expressing gratitude, finding meaning, and fostering connections. Preliminary pilot study results were promising, showing reduced depressive symptoms and increased resilience in participants. The purpose of the current study is to conduct a Stage II efficacy trial of the 8-week ReStoreD intervention with a sample of 200 dyads (n=400) consisting of one individual who has sustained an ischemic or hemorrhagic stroke between 3 months and 3 years prior to enrollment and a cohabitating carepartner. Using a fully-powered, randomized waitlist-control design, we will determine efficacy of ReStoreD to reduce emotional distress in both dyad members (Aim 1). We will also examine effects of ReStoreD on secondary outcomes (resilience, relationship quality, stress- related stroke, meaningful activity engagement) as potential mediators (Aim 2), and explore moderators to determine whether certain subgroups respond better to the intervention (Aim 3). All participants will complete standardized, validated assessments at baseline, 8 weeks, 16 weeks, and 6-month follow up. All aspects of the study, including intervention activities and assessments, are conducted remotely, online. This is the first rigorously designed efficacy trial to test a positive psychology intervention for stroke survivors and their carepartners. When the aims of this study are realized, we will 1) have a remotely-delivered, dyadic intervention to support couples post-stroke; 2) have a better understanding of the mechanisms involved in the intervention's effect on emotional distress, and can use this information to inform future interventions; and 3) be able to identify a more specific target population for whom the intervention works best. Ultimately, if found efficacious, this intervention will offer sustainable and accessible support for couples who are coping with stroke to improve rehabilitation outcomes and quality of life.