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Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke
Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.ORCID iD: 0000-0001-5082-8998
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.ORCID iD: 0000-0002-5308-4821
Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden;Karolinska Univ Hosp, Neuro, Stockholm, Sweden.
Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.ORCID iD: 0000-0001-6878-6394
2019 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 2, p. 262-276Article in journal (Refereed) Published
Abstract [en]

Objective: To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.

Design: Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention (n = 129) or usual ADL interventions (n = 151) were delivered to people with stroke.

Setting: Multicentre study including 16 inpatient or home-based rehabilitation units.

Participants: People with stroke and significant others.

Intervention: The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.

Main measures: For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.

Results: Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).

Conclusion: The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

Place, publisher, year, edition, pages
2019. Vol. 33, no 2, p. 262-276
Keywords [en]
Stroke rehabilitation, rehabilitation, occupational therapy, follow-up studies, evaluation studies, longitudinal studies, caregivers
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:uu:diva-377337DOI: 10.1177/0269215518809791ISI: 000456887100012PubMedID: 30409049OAI: oai:DiVA.org:uu-377337DiVA, id: diva2:1291511
Funder
Swedish Research CouncilAvailable from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25Bibliographically approved

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Eriksson, Gunilla

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