skip to main content

The Effect of “SELF-HELP Packages” on Post Stroke Depression among Ischemic Stroke Survivors

*Fitria Handayani orcid  -  Universitas Diponegoro, Indonesia
Setyowati Setyowati  -  University of Indonesia, Indonesia
Dwi Pudjonarko  -  Universitas Diponegoro, Indonesia
Dian Ratna Sawitri  -  Universitas Diponegoro, Indonesia
Open Access Copyright (c) 2020 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: There are several factors that contribute to Post Stroke Depression (PSD). Since a single intervention is proven ineffective to deal with PSD, an intervention which includes biological, psychological, social, and spiritual aspects (“SELF-HELP Packages”), therefore, needs to be established.

Purpose: The purpose of the study was to investigate the effect of “SELF HELP Packages” intervention on PSD among ischemic stroke survivors after three months from onset and its effect after confounding variables were controlled.

Methods: This study was a pre and post quasi-experiment with a control group involving 34 ischemic stroke survivors each group. The inclusion criteria were survivors after three months from ischemic stroke, no aphasia, having a good hearing, and having Mini Mental Status Examination (MMSE) score of ≥ 22. GRID-HAMD 17, Multidimensional Scale of Perceived Social Support (MSPSS), and Barthel-Index were used to measure PSD, social support, and functional status respectively. “SELF-HELP Packages” intervention was delivered in three sessions, namely information delivery, discussion and activity. Statistical analyses were conducted using McNemar test, Chi-square and logistic regression.

Results: The result showed that “SELF-HELP Packages” considerably decreased PSD in the intervention group (p=0.004). There were also significant differences in PSD after the intervention between two groups (p=0.008). Logistic regression showed that ‘SELF-HELP Package” had no effect on PSD when other confounding variables were controlled (p=0.075, OR=0.288, 95% CI 0.073 – 1.135).

Conclusion: SELF-HELP Packages” should be applied in providing the nursing intervention among stroke ischemic survivors in clinical setting. A longer period of time for the intervention is also recommended for the next study in order to obtain a more robust result.  

 

Fulltext View|Download
Keywords: Ischemic stroke; post stroke depression; “SELF-HELP Packages” intervention

Article Metrics:

  1. Abdi, A., Soufinia, A., Borji, M., & Tarjoman, A. (2019). The effect of religion intervention on life satisfaction and depression in elderly with heart failure. Journal of Religion and Health, 58(3), 823–832. doi: 10.1007/s10943-018-0727-7
  2. Agianto, A. (2018). Role and function of family in care of patients with stroke in the community, Indonesia. Dunia Keperawatan, 6(2). doi: 10.20527/dk.v6i2.5226
  3. Aranda, S. (2008). Designing nursing interventions. Collegian, 15(1), 19–25. doi: 10.1016/j.colegn.2007.11.002
  4. Bach, P., Hayes, S. C., & Gallop, R. (2012). Long-term effects of brief acceptance and commitment therapy for psychosis. Behavior Modification, 36(2), 165–181. doi: 10.1177/0145445511427193
  5. Bartoli, F., Di Brita, C., Crocamo, C., Clerici, M., & Carràl, G. (2018). Early post-stroke depression and mortality: Meta-analysis and meta-regression. Frontiers in Psychiatry, 9(November), 1–7. doi: 10.3389/fpsyt.2018.00530
  6. Byrne, J. L., Dallosso, H. M., Rogers, S., Gray, L. J., Waheed, G., Patel, P., … Khunti, K. (2020). Effectiveness of the Ready to Reduce Risk (3R) complex intervention for the primary prevention of cardiovascular disease: A pragmatic randomised controlled trial. BMC Medicine, 18(1), 1–13. doi: 10.1186/s12916-020-01664-0
  7. Chau, J. P. C., Thompson, D. R., Chang, A. M., Woo, J., Twinn, S., Cheung, S. K., & Kwok, T. (2010). Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital. Journal of Clinical Nursing, 19(21–22), 3042–3050. doi: 10.1111/j.1365-2702.2010.03317.x
  8. De Wit, L., Putman, K., Baert, I., Lincoln, N. B., Angst, F., Beyens, H., … Feys, H. (2008). Anxiety and depression in the first six months after stroke: A longitudinal multicentre study. Disability and Rehabilitation, 30(24), 1858–1866. doi: 10.1080/09638280701708736
  9. Dharma, K. K. (2015). Efektifitas intervensi model adaptasi paska stroke (IMAPS) terhadap respon adaptasi dan kualitas hidup pasien paska stroke [the effectiveness of post-stroke adaptation model intervention (IMAPS) on the adaptation response and the quality of life of post-stroke]. Retrieved from http://lib.ui.ac.id/detail?id=20416058&lokasi=lokal
  10. Dharma, K. K., Damhudi, D., Yardes, N., & Haeriyanto, S. (2018). Increase in the functional capacity and quality of life among stroke patients by family caregiver empowerment program based on adaptation model. International Journal of Nursing Sciences, 5(4), 357–364. doi: 10.1016/j.ijnss.2018.09.002
  11. Donkor, E. S. (2018). Stroke in the 21 st century : A snapshot of the burden, epidemiology, and quality of life. Stroke Research and Treatment, 2018, 1–10. doi: 10.1155/2018/3238165
  12. Du, H. S., Ma, J. J., & Li, M. (2016). High-quality health information provision for stroke patients. Chinese Medical Journal, 129(17), 2115–2122. doi: 10.4103/0366-6999.189065
  13. Ebert, D. D., Nobis, S., Lehr, D., Baumeister, H., Riper, H., Auerbach, R. P., … Berking, M. (2017). The 6-month effectiveness of Internet-based guided self-help for depression in adults with Type 1 and 2 diabetes mellitus. Diabetic Medicine, 34(1), 99–107. doi: 10.1111/dme.13173
  14. Evans-Hudnall, G. L., Stanley, M. A., Clark, A. N., Bush, A. L., Resnicow, K., Liu, Y., … Sander, A. M. (2014). Improving secondary stroke self-care among underserved ethnic minority individuals: A randomized clinical trial of a pilot intervention. Journal of Behavioral Medicine, 37(2), 196–204. doi: 10.1007/s10865-012-9469-2
  15. Gbiri, C. A., Akinpelu, A. O., & Odole, A. C. (2010). Prevalence, pattern and impact of depression on quality of life of stroke survivors. International Journal of Psychiatry in Clinical Practice, 14, 198–203. doi: 10.3109/13651501003797633
  16. Gregg, J. A., Callaghan, G. M., Hayes, S. C., & Glenn-Lawson, J. L. (2007). Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 75(2), 336–343. doi: 10.1037/0022-006X.75.2.336
  17. Guiraud, V., Gallarda, T., Calvet, D., Turc, G., Oppenheim, C., Rouillon, F., & Mas, J.-L. (2016). Depression predictors within six months of ischemic stroke: The DEPRESS Study. International Journal of Stroke, 0(0), 1–7. doi: 10.1177/1747493016632257
  18. Hackett, M. L., Köhler, S., O’Brien, J. T., & Mead, G. E. (2014). Neuropsychiatric outcomes of stroke. Lancet Neurology, 13(5), 525–534. doi: 10.1016/S1474-4422(14)70016-X
  19. Handayani, F., & Pudjonarko, D. (2015). Associated factor and Predictor of Post Stroke Depression after 3 month onset: A Literature Review. The proceeding of 3rd Java International Nursing Conference. Semarang
  20. Handayani, F., Setyowati, Pudjonarko, D., & Sawitri, D. R. (2019). Psychosocial associated and predictors of post stroke Depression 3-6 months after onset: A systematic review. Pakistan Journal of Medical and Health Sciences, 13(4), 1219–1223
  21. Health Office of Semarang City. (2020). Semarang City Health Profile 2019. Accessed on October 30, 2020. Retrieved from http://www.depkes.go.id/resources/download/profil/PROFIL_KAB_KOTA_2015/3374_Jateng_Kota_Semarang_2015.pdf
  22. Holmgren, E., Lindström, B., Gosman-Hedström, G., Nyberg, L., & Wester, P. (2010). What is the benefit of a high intensive exercise program? A randomized controlled trial. Advances in Physiotherapy, 12(May), 115–124. doi: 10.3109/14038196.2010.491555
  23. Hubbard, J. R., & Workman, E. A. (1998). Handbook of Stress Medicine Editors Roanoke / Salem Residency Training Program. New York: CRC Press
  24. Kang, H. J., Bae, K. Y., Kim, S. W., Lee, E. H., Kim, J. T., Park, M. S., … Kim, J. M. (2018). Impact of acute phase depression on functional outcomes in stroke patients over 1 year. Psychiatry Research, 267, 228–231. doi: 10.1016/j.psychres.2018.06.026
  25. Karekla, M., Karademas, E. C., & Gloster, A. T. (2018). The common sense model of self-regulation and acceptance and commitment therapy: Integrating strategies to guide interventions for chronic illness. Health Psychology Review, 0(0), 1–14. doi: 10.1080/17437199.2018.1437550
  26. Khashouei, M. M., Ghorbani, M., & Tabatabaei, F. (2016). The Effectiveness of Acceptance and Commitment Therapy (ACT) on Self-Efficacy, Perceived Stress and Resiliency in Type II Diabetes Patients. Global Journal of Health Science, 9(5), 18. https://doi.org/10.5539/gjhs.v9n5p18
  27. Kielbergerova, L., Mayer, O.-J., Vanak, J., Bruthans, J., Wohlfahrt, P., & Ciffkova, R. (2015). Quality of life predictors in chronic stable post-stroke patients and prognostic value of SF-36 score as a mortality surrogate. Translational Stroke Research, 6(5), 375–383. doi: 10.1007/s12975-015-0418-6
  28. Lerdal, A., Bakken, L. N., Rasmussen, E. F., Beiermann, C., Ryen, S., Pynten, S., … Kim, H. S. (2011). Physical impairment, depressive symptoms and pre-stroke fatigue are related to fatigue in the acute phase after stroke. Disability and Rehabilitation, 33(4), 334–342. doi: 10.3109/09638288.2010.490867
  29. Li, J., Zhao, Y., Zeng, J., Chen, X., Wang, R., & Cheng, S. (2014). Serum brain-derived neurotrophic factor levels in post-stroke depression. Journal of Affective Disorders, 168, 373–379. doi: 10.1016/j.jad.2014.07.011
  30. Lin, F. H., Yih, D. N., Shih, F. M., & Chu, C. M. (2019). Effect of social support and health education on depression scale scores of chronic stroke patients. Medicine, 98(44), e17667. doi: 10.1097/MD.0000000000017667
  31. Lincoln, N. B., Brinkmann, N., Cunningham, S., Dejaeger, E., De Weerdt, W., Jenni, W., … De Wit, L. (2013). Anxiety and depression after stroke: A 5 year follow-up. Disability and Rehabilitation, 35(2), 140–145. doi: 10.3109/09638288.2012.691939
  32. Lindholm-Olinder, A., Fischier, J., Fries, J., Alfonsson, S., Elvingson, V., Eriksson, J. W., & Leksell, J. (2015). A randomised wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes: A study protocol. BMC Nursing, 14(1), 61. doi: 10.1186/s12912-015-0101-y
  33. Loubinoux, I., Kronenberg, G., Endres, M., Schumann-Bard, P., Freret, T., Filipkowski, R. K., … Popa-Wagner, A. (2012). Post-stroke depression: Mechanisms, translation and therapy. Journal of Cellular and Molecular Medicine, 16(9), 1961–1969. doi: 10.1111/j.1582-4934.2012.01555.x
  34. Lucchetti, G., Lucchetti, A. L. G., & Koenig, H. G. (2011). Impact of spirituality/religiosity on mortality: Comparison with other health interventions. Explore: The Journal of Science and Healing, 7(4), 234–238. doi: 10.1016/j.explore.2011.04.005
  35. Mahdavi, A., Aghaei, M., Aminnasab, V., Tavakoli, Z., Besharat, M., & Abedin, M. (2017). The effectiveness of acceptance-commitment therapy (ACT) on perceived stress, symptoms of depression, and marital satisfaction in women with breast cancer. Archives of Breast Cancer, (August), 16–23. doi: 10.19187/abc.20174116-23
  36. Majumdar, S., & Morris, R. (2018). Brief group-based acceptance and commitment therapy for stroke survivors. British Journal of Clinical Psychology, 1–21. doi: 10.1111/bjc.12198
  37. Mayo, N. E., Anderson, S., Barclay, R., Cameron, J. I., Desrosiers, J., Eng, J. J., … Bayley, M. (2015). Getting on with the rest of your life following stroke: A randomized trial of a complex intervention aimed at enhancing life participation post stroke. Clinical Rehabilitation, 29(12), 1198–1211. doi: 10.1177/0269215514565396
  38. Mayo, N. E., & Scott, S. (2011). Evaluating a complex intervention with a single outcome may not be a good idea: An example from a randomised trial of stroke case management. Age and Ageing, 40(6), 718–724. doi: 10.1093/ageing/afr061
  39. Medical Research Council. (2014). Developing and evaluating complex interventions : new guidance. Accessed on October 30, 2018. Retrieved from www.mrc.ac.uk/complexinterventionsguidance
  40. Ministry of Health The Republic of Indonesia. (2018). Laporan Nasional RISKESDAS 2018 [Report of National Fundamental Health Research 2018]. Accessed on October 30, 2020. Retrieved from http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf
  41. Moon, Y. S., & Kim, D. H. (2013). Association between religiosity/spirituality and quality of life or depression among living-alone elderly in a South Korean city. Asia-Pacific Psychiatry, 5(4), 293–300. doi: 10.1111/appy.12025
  42. Mundle, R. (2015). “I should be closer to God because of this”—A case study of embodied narratives and spiritual reconstruction in spinal cord injury and stroke rehabilitation. Journal of Disability and Religion, 19(1), 30–49. doi: 10.1080/23312521.2014.990551
  43. Ning, X. S., & Te, Z. (2013). Public and professional education on urgent therapy for acute ischemic stroke : a community-based intervention in Changsha. Neurological Sciences, 2131–2135. doi: 10.1007/s10072-013-1348-2
  44. Ojagbemi, A., & Owolabi, M. (2013). Predictors of functional dependency after stroke in Nigeria. Journal of Stroke and Cerebrovascular Diseases, 22(8), e381–e387. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.015
  45. Patrick, D. L., Burke, L. B., Gwaltney, C. J., Leidy, N. K., Martin, M. L., Molsen, E., & Ring, L. (2011). Content validity - Establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: Part 1 - Eliciting concepts for a new PRO instru. Value in Health, 14(8), 967–977. doi: 10.1016/j.jval.2011.06.014
  46. Philip, K. D., & Harris, R. (2014). Nursing Theorist and Their Work (M. R. Alligood, Ed.). St. Louis, Missouri: Elsevier Mosby
  47. Promega. (2009). BDNF E max ® ImmunoAssay. USA
  48. Sabariego, C., Barrera, A. E., Neubert, S., Stier-jarmer, M., Bostan, C., & Cieza, A. (2013). Evaluation of an ICF-based patient education programme for stroke patients: A randomized, single-blinded, controlled, multicentre trial of the effects on self-efficacy, life satisfaction and functioning. British Journal of Health Psychology, 18, 707–728. doi: 10.1111/bjhp.12013
  49. Sakamoto, H., Maki, N., Utsugi, A., Takata, Y., Kubota, T., Kubota, T., … Yanagi, H. (2018). The effect of cognitive rehabilitation for post-stroke depression in long-term care health facilities: A randomized controlled trial. Clinical and Medical Investigations, 3(2), 1–7. doi: 10.15761/cmi.1000157
  50. Shi, Y., Yang, D., Zeng, Y., & Wu, W. (2017). Risk factors for post-stroke depression: A meta-analysis. Frontiers in Aging Neuroscience, 9, 218. doi: 10.3389/fnagi.2017.00218
  51. Shi, Y. Z., Xiang, Y. T., Yang, Y., Zhang, N., Wang, S., Ungvari, G. S., … Wang, C. X. (2015). Depression after minor stroke: Prevalence and predictors. Journal of Psychosomatic Research, 79(2), 143–147. doi: 10.1016/j.jpsychores.2015.03.012
  52. Silakarma, D., & Sudewi, A. A. R. (2019). The role of brain-derived neurotrophic factor (BDNF) in cognitive functions. Bali Medical Journal, 8(2), 518. doi: 10.15562/bmj.v8i2.1460
  53. Stein, J., Bettger, J. P., Sicklick, A., Hedeman, R., Magdon-Ismail, Z., & Schwamm, L. H. (2015). Use of a standardized assessment to predict rehabilitation care after acute stroke. Archives of Physical Medicine and Rehabilitation, 96(2), 210–217. doi: 10.1016/j.apmr.2014.07.403
  54. The Joanna Briggs Institute. (2010). The Joanna Briggs Institute best practice information sheet : The psychosocial and spiritual experiences of elderly individuals recovering from a stroke. Nursing and Health Sciences, 12(4), 515–518. doi: 10.1111/j.1442-2018.2010.00555.x
  55. Vallury, K. D. B., Jones, M., & Gray, R. (2015). Do family-oriented interventions reduce poststroke depression? A systematic review and recommendations for practice. Topics in Stroke Rehabilitation, 22(6), 453–459. doi: 10.1179/1074935715Z.00000000061
  56. Warber, S. L., Ingerman, S., Moura, V. L., Wunder, J., Northrop, A., Gillespie, B. W., …, Rubenfire, M. (2011). Healing the heart: A randomized pilot study of a spiritual retreat for depression in acute coronary syndrome patients. Explore: The Journal of Science and Healing, 7(4), 222–233. doi: 10.1016/j.explore.2011.04.002
  57. Webber, P. B., & Newby, C. P. (2015). An introduction to reasoning and nursing theory (4th ed.). B. M. Johnson & P. B. Webber (Eds.). Philadelphia: Wolters Kluwer Health | Lippincott Williams & Wilkins
  58. Williams, J. B. W., Kobak, K. A., Bech, P., Engelhardt, N., Evans, K., Lipsitz, J., … Pearson, J. (2008). The GRID-HAMD : Standardization of the Hamilton Depression Rating Scale. International Clinical Psychopharmacology, 23, 120–129. doi: 10.1097/YIC.0b013e3282f948f5
  59. Wills, E. M. (2011). Theoretical Basis in Nursing (3rd ed.). M. McEwen & E. M. Wills (Eds.). Philadelphia: Wolters Kluwer Health | Lippincott Williams & Wilkins
  60. World Health Organization. (2019). Monitoring Health for The SDGs, sustainable development goals. World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/324835
  61. Yuan, H. W., Wang, C. X., Zhang, N., Bai, Y., Shi, Y. Z., Zhou, Y., … Wang, Y. J. (2012). Poststroke depression and risk of recurrent stroke at 1 year in a chinese cohort study. PLoS ONE, 7(10), e46906. doi: 10.1371/journal.pone.0046906
  62. Zhang, T., Jing, X., Zhao, X., Wang, C., Liu, Z., Zhou, Y., … Wang, Y. (2012). A prospective cohort study of lesion location and its relation to post-stroke depression among Chinese patients. Journal of Affective Disorders, 136(1–2), e83-7. doi.org:10.1016/j.jad.2011.06.014
  63. Zimmermann, T., Puschmann, E., Ebersbach, M., Daubmann, A., Steinmann, S., & Scherer, M. (2014). Effectiveness of a primary care based complex intervention to promote self-management in patients presenting psychiatric symptoms: Study protocol of a cluster-randomized controlled trial. BMC Psychiatry, 14(1). doi: 10.1186/1471-244X-14-2
  64. Zimmermann, T., Puschmann, E., van den Bussche, H., Wiese, B., Ernst, A., Porzelt, S., … Scherer, M. (2016). Collaborative nurse-led self-management support for primary care patients with anxiety, depressive or somatic symptoms: Cluster-randomised controlled trial (findings of the SMADS study). International Journal of Nursing Studies, 63, 101–111. doi: 10.1016/j.ijnurstu.2016.08.007

Last update:

  1. Impact of a spiritual care program on the sleep quality and spiritual health of Muslim stroke patients: A randomized controlled trial

    Vahid Yousofvand, Mohammad Torabi, Khodayar Oshvandi, Saeid Kazemi, Salman Khazaei, Mojtaba Khazaei, Azim Azizi. Complementary Therapies in Medicine, 77 , 2023. doi: 10.1016/j.ctim.2023.102981
  2. 7,8‑Dihydroxyflavone functions as an antioxidant through the inhibition of Kelch‑like ECH‑associated protein 1: Molecular docking and an in vivo approach in a rat model of ischemia‑reperfusion brain injury

    Yuyun Yueniwati, Mokhamad Syaban, Dedy Kurniawan, Afrizal Azam, Desak Alvenia, Yushidayah Savira, Rislan Muhammad, Basyar Adnani, Aldita Violita, Safira Arviana, Aminah Hasibuan, Eviana Norahmawati, Yasmin Fatmasari, Arinal Mufidah, Kania Savitri, Unzila Zulfikri, Diana Putri, Sri Utami. World Academy of Sciences Journal, 6 (2), 2024. doi: 10.3892/wasj.2024.230
  3. The Associated Factors of Quality of Life among Stroke Survivors: A Study in Indonesia

    Fitria Handayani, Reni Sulung Utami, Chandra Bagus Ropyanto, Niken Safitri Dyan Kusumaningrum, Yuni Dwi Hastuti. Nurse Media Journal of Nursing, 12 (3), 2022. doi: 10.14710/nmjn.v12i3.45763
  4. Effect of a Hospital-To-Home Transitional Intervention Based on an Interaction Model of Client Health Behavior for Adult Patients with Stroke

    Su-Jin Cho, Sung Reul Kim, Kyung-Hee Cho, Nah-Mee Shin, Won-Oak Oh. Journal of Community Health Nursing, 40 (4), 2023. doi: 10.1080/07370016.2023.2227154

Last update: 2024-10-06 01:48:17

No citation recorded.