Stress in caregivers of aphasic stroke patients: a randomized controlled trial

Background: Communication difficulties due to aphasia following stroke are particularly stressful to caregivers. Objective: To examine the impact of a psychoeducation programme on caregivers, burden and stress and communication between the caregiver and aphasic stroke patient. Design: Randomized wait-list controlled trial with immediate or three-month delayed treatment. Setting: Three public hospital rehabilitation services in Sydney, Australia. Subjects: Thirty-nine caregivers of aphasic stroke patients, up to 12 months post stroke: 19 given immediate treatment and 20 in a delayed treatment control group. Interventions: Four-session weekly caregiver programme that included elements of education, support and communication skills conducted by a speech pathologist, social worker and clinical psychologist. Main measures: The General Health Questionnaire (GHQ) was used to measure caregiver stress, the Relatives' Stress Scale was used to measure caregiver burden and a communication questionnaire was designed specifically for this project. Results: Thirty-one caregivers completed the study. Caregivers in the immediate treatment group had significant reductions in GHQ measured stress (GHQ mean (SD) at baseline = 6.26 (5.67), GHQ post treatment 3.21 (SD 4.20), P= 0.006). There was no improvement in wait-listed caregivers. Improvement was not maintained at three-month follow-up. There were no significant effects of the programme on communication skills or on caregiver burden. Conclusions: Stroke caregiver support, education and training programmes have short-term effects on caregiver stress levels but are likely to require ongoing involvement to maintain their effect.