Social support interventions and mood status post stroke: a review.

OBJECTIVE

Psychological consequences of stroke are important determinants of health-related quality of life. As many as one-third of individuals with stroke will experience post-stroke depression; however, perceived social support may be protective in terms of both onset and duration of depressed mood. Improvement of available social support could be an important strategy in reducing or preventing psychiatric distress and warding off post-stroke depression. The present paper will examine the impact of social support interventions on depression or mood status in individuals with stroke.

DESIGN

Literature review.

DATA SOURCES

PubMed, CINAHL, EMBASE, PsychINFO and Cochrane Collection databases.

REVIEW METHODS

Descriptions of study participants and interventions, method and timing of the assessment for depression or mood and results pertaining to those outcomes were abstracted from identified studies. Each study was assessed in terms of methodological quality. Results of similar treatments were compared and evaluated descriptively.

RESULTS

Ten (10) randomized controlled trials were identified for inclusion in the present review. Seven examined similar home-based support and care coordination interventions including family support organizers and nursing outreach programs. The three remaining studies described: (i) a social support intervention, (ii) family counselling in addition to education and (iii) a social/occupational day service. Only one trial describing a care coordination model reported a significant, positive effect on depression over time associated with receipt of the trial intervention.

CONCLUSIONS

Identified components of care, which distinguished the sole successful trial from those that were unsuccessful, include early initiation, increased intensity of regularly scheduled, worker-initiated contact, ongoing assessment including screening for depression and provision of counselling as required. Future studies should incorporate these elements as well as address methodological issues.