Key result
WAterS online intervention linked to a ~1.3-point reduction in depression scores among stroke survivors.
Why the study?
Feasibility of a co-developed Acceptance and Commitment Therapy intervention to support psychological adjustment after stroke was not established.
Does the WAterS ACT intervention improve psychological adjustment in stroke survivors with psychological distress?
Observational (n=17)
Does the WAterS ACT intervention improve psychological adjustment in stroke survivors with psychological distress?
Mean Difference: 1.3 (95% CI 0.4–3.2)
A co-developed, online Acceptance and Commitment Therapy intervention is feasible and safe for stroke survivors, showing potential signals of improved mood.
May support online ACT for post-stroke distress; leaves open efficacy without randomized trials.
Objective Feasibility test a co-developed intervention based on Acceptance and Commitment Therapy (ACT) to support psychological adjustment post-stroke, delivered by a workforce with community in-reach. Design Observational feasibility study utilising Patient, Carer, Public Involvement (PCPI). Setting Online. UK. Participants Stroke survivors with self-reported psychological distress 4+ months post-stroke Interventions The co-developed Wellbeing After Stroke (WAterS) intervention includes: nine weekly, structured, online, group sessions for stroke survivors, delivered via a training programme to upskill staff without previous ACT experience, under Clinical Psychology supervision. Main measures Feasibility of recruitment and retention; data quality from candidate measures; safety. Clinical and demographic information at baseline; Patient Reported Outcome Measures (PROMs) via online surveys (baseline, pre- and post-intervention, 3 and 6 months after intervention end) including Mood (HADS), Wellbeing (ONS4), Health-Related Quality of Life (EQ5D5L), Psychological Flexibility (AAQ-ABI) and Values-Based Living (VQ). Results We trained eight staff and recruited 17 stroke survivors with mild-to-moderate cognitive and communication difficulties. 12/17 (71%) joined three intervention groups with 98% attendance and no related adverse events. PROMS data were well-completed. The HADS is a possible future primary outcome (self-reported depression lower on average by 1.3 points: 8.5 pre-group to 7.1 at 3 month follow up; 95% CI 0.4 to 3.2). Conclusion The WAterS intervention warrants further research evaluation. Staff can be trained and upskilled to deliver. It appears safe and feasible to deliver online to groups, and study recruitment and data collection are feasible. Funding has been secured to further develop the intervention, considering implementation and health equality.
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Patchwood et al. (2023) conducted an observational in Psychological distress post-stroke (n=17). Wellbeing After Stroke (WAterS) intervention was evaluated on Change in HADS depression score at 3 months (MD 1.3, 95% CI 0.4-3.2). The WAterS online group intervention was feasible to deliver to stroke survivors, achieving 98% attendance and reducing self-reported depression scores by an average of 1.3 points at 3 months.
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