A new study is investigating the effectiveness of the Dyadic Coping Intervention of Social Participation (DCISP) for first-time stroke survivors and their spouses. The single-blind, randomized controlled trial, taking place across three tertiary hospitals in Shanghai, aims to enhance social participation and overall quality of life for stroke patients by actively involving their spouses in the recovery process. Researchers will evaluate the feasibility and effectiveness of DCISP on social participation, stroke knowledge, quality of life, caregiver burden, and dyadic coping within the survivor-spouse relationship.
The study, which commenced recruitment on August 1, 2023, and is expected to continue until August 1, 2025, will enroll 100 survivor-spouse dyads. Participants are randomly assigned to either the experimental group receiving DCISP or a control group receiving standard care, including health education and regular telephone follow-ups. The DCISP intervention spans three months, with bi-weekly sessions lasting 40-45 minutes each. Follow-up assessments will occur at 1-month, 3-month, and 6-month intervals.
Intervention Details
The DCISP intervention consists of six key themes: daily living skills, dyadic communication and emotion regulation, family roles and indoor participation, interpersonal communication and stress management, outdoor participation, and reintegration into social life. Each session involves both the stroke survivor and their spouse, focusing on problem-solving, health education, and skill-building to promote active participation in daily activities. Researchers provide self-management manuals and psychological support to enhance compliance and address any challenges encountered during the intervention.
The control group receives standard post-discharge care, including medication management, homebound rehabilitation, health education, and regular telephone follow-ups. This ensures that all participants receive a baseline level of support, allowing for a clear comparison of the added benefits of the DCISP intervention.
Outcome Measures
The study employs a range of validated questionnaires to assess both primary and secondary outcomes. Primary outcomes for stroke survivors include social participation levels, measured using the Impact on Participation and Autonomy Questionnaire (IPA) and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P). Secondary outcomes include stroke knowledge (assessed via the Knowledge Questionnaire for Stroke Patients, SPKQ), quality of life (measured by the Stroke-Specific Quality of Life scale, SS-QOL), and functional recovery (evaluated using the Modified Rankin Scale, mRS).
For spouses, the Zarit Caregiver Burden Interview (ZBI-22) will measure caregiver burden, while the Dyadic Coping Inventory (DCI) will assess dyadic coping strategies within the survivor-spouse relationship. These comprehensive assessments aim to provide a holistic understanding of the intervention's impact on both the stroke survivor and their caregiver.
Data Analysis
Data will be analyzed using SPSS 22.0 software, with baseline data compared using chi-square tests and independent samples t-tests. Intervention effects will be evaluated using independent samples t-tests for normally distributed data and non-parametric tests for non-normally distributed data. A linear mixed model will be used to compare outcome measures over time, considering differences between the groups and the interaction between time and group. Intention-to-treat analysis will be conducted to manage missing data.
This study has received ethical approval from the Institutional Review Board of Shanghai University of Traditional Chinese Medicine and is registered in the Chinese Clinical Trial Registry (ChiCTR2400083072).
