HeART of Stroke: randomised controlled, parallel-arm, feasibility study of a community-based arts and health intervention plus usual care compared with usual care to increase psychological well-being in people following a stroke.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
08 03 2019
Historique:
entrez: 11 3 2019
pubmed: 11 3 2019
medline: 13 3 2020
Statut: epublish

Résumé

People often experience distress following stroke due to fundamental challenges to their identity. To evaluate (1) the acceptability of 'HeART of Stroke' (HoS), a community-based arts and health group intervention, to increase psychological well-being; and (2) the feasibility of a definitive randomised controlled trial (RCT). Two-centre, 24-month, parallel-arm RCT with qualitative and economic components. Randomisation was stratified by centre and stroke severity. Participant blinding was not possible. Outcome assessment blinding was attempted. Community. Community-dwelling adults ≤2 years poststroke recruited via hospital clinical teams/databases or community stroke/rehabilitation teams. Artist-facilitated arts and health group intervention (HoS) (ten 2-hour sessions over 14 weeks) plus usual care (UC) versus UC. The outcomes were self-reported measures of well-being, mood, capability, health-related quality of life, self-esteem and self-concept (baseline and 5 months postrandomisation). Key feasibility parameters were gathered, data collection methods were piloted, and participant interviews (n=24) explored the acceptability of the intervention and study processes. Despite a low recruitment rate (14%; 95% CI 11% to 18%), 88% of the recruitment target was met, with 29 participants randomised to HoS and 27 to UC (57% male; mean (SD) age=70 (12.1) years; time since stroke=9 (6.1) months). Follow-up data were available for 47 of 56 (84%; 95% CI 72% to 91%). Completion rates for a study-specific resource use questionnaire were 79% and 68% (National Health Service and societal perspectives). Five people declined HoS postrandomisation; of the remaining 24 who attended, 83% attended ≥6 sessions. Preliminary effect sizes for candidate primary outcomes were in the direction of benefit for the HoS arm. Participants found study processes acceptable. The intervention cost an estimated £456 per person and was well-received (no intervention-related serious adverse events were reported). Findings from this first community-based study of an arts and health intervention for people poststroke suggest a definitive RCT is feasible. Recruitment methods will be revised. ISRCTN99728983.

Identifiants

pubmed: 30852528
pii: bmjopen-2017-021098
doi: 10.1136/bmjopen-2017-021098
pmc: PMC6429750
doi:

Banques de données

ISRCTN
['ISRCTN99728983']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e021098

Subventions

Organisme : Department of Health
ID : PB-PG-0212-27054
Pays : United Kingdom

Informations de copyright

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Caroline Ellis-Hill (C)

Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.

Sarah Thomas (S)

Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.

Fergus Gracey (F)

Department of Clinical Psychology, University of East Anglia, Norwich, UK.
The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Ely, UK.

Catherine Lamont-Robinson (C)

School of Social and Community Medicine, University of Bristol, Bristol, UK.

Robin Cant (R)

Service User, (formerly of Canterbury Christ Church University), Canterbury, Kent, UK.

Elsa M R Marques (EMR)

Bristol Medical School, University of Bristol, Bristol, UK.

Peter W Thomas (PW)

Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.

Mary Grant (M)

Clinical Trials Unit, University of Warwick, Coventry, UK.

Samantha Nunn (S)

The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust, Ely, UK.

Thomas Paling (T)

Bristol Medical School, University of Bristol, Bristol, UK.

Charlotte Thomas (C)

Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.

Alessa Werson (A)

Department of Clinical Psychology, University of East Anglia, Norwich, UK.

Kathleen T Galvin (KT)

School of Health Sciences, University of Brighton, Brighton, UK.

Frances Reynolds (F)

College of Health and Life Sciences, Brunel University London, Uxbridge, UK.

Damian Jenkinson (D)

Stroke Unit, Dorset County Hospital, Dorchester, UK.

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