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

项目总结/摘要 中风的影响由中风幸存者和他们的配偶/伴侣照顾者（照顾伴侣）分担。 据估计，30-50%的中风幸存者和护理伙伴经历抑郁或焦虑症状， 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 很大程度上是不充分的或无法获得的。为了满足这一需求，我们开发了一种新型的远程交付的二元 干预，以促进恢复中风幸存者-护理伙伴二人组（ReStoreD），其中夫妇学习 并练习目标设定，沟通策略和积极的心理学活动，如表达 感恩，寻找意义，培养联系。初步试点研究结果令人鼓舞，表明 减少参与者的抑郁症状，增加他们的韧性。本研究的目的是 使用200对样本进行为期8周的ReStoreD干预的II期疗效试验（n=400） 由一个在3个月至3个月之间持续缺血性或出血性中风的个体组成 年前登记和同居护理伴侣。使用完全有效的随机等待列表对照 设计，我们将确定ReStoreD减少两个二分体成员的情绪困扰的功效（目标1）。 我们还将研究ReStoreD对次要结果（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），并探索调解人， 确定某些亚组是否对干预反应更好（目标3）。所有参与者将完成 在基线、8周、16周和6个月随访时进行标准化、经验证的评估。的所有方面 研究，包括干预活动和评估，都是远程在线进行的。 这是第一个严格设计的有效性试验，以测试中风幸存者的积极心理干预 和他们的护理伙伴。当本研究的目的实现时，我们将1）有一个远程交付的， 干预，以支持夫妇中风后; 2）有一个更好的了解机制，参与 干预对情绪困扰的影响，并可以使用这些信息为未来的干预提供信息;以及3） 能够确定干预措施最适合的更具体的目标人群。最终，如果发现 有效，这种干预将提供可持续的和可获得的支持，为夫妇谁是应对 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.