Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review

Madeleine Hinwood; Marina Ilicic; Prajwal Gyawali; Kirsten Coupland; Murielle G Kluge; Angela Smith; Sue Bowden; Michael Nilsson; Frederick Rohan Walker

doi:10.1093/abm/kaac002

Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review

Ann Behav Med. 2023 Feb 4;57(2):111-130. doi: 10.1093/abm/kaac002.

Authors

Madeleine Hinwood^{1

2}, Marina Ilicic^{2

3

4}, Prajwal Gyawali⁵, Kirsten Coupland^{2

3

4}, Murielle G Kluge^{3

6}, Angela Smith⁷, Sue Bowden⁸, Michael Nilsson^{2

9

10}, Frederick Rohan Walker^{2

3

4

6

9}

Affiliations

¹ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.
² Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
³ School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia.
⁴ Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.
⁵ School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Darling Heights, QLD, Australia.
⁶ Centre for Advanced Training Systems, The University of Newcastle, Callaghan, NSW, Australia.
⁷ HNE Health Libraries, Hunter New England Local Health District, New Lambton, NSW, Australia.
⁸ Consumer Investigator, Moon River Turkey, Bathurst, NSW, Australia.
⁹ Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia.
¹⁰ LKC School of Medicine, Nanyang Technological University, Singapore.

Abstract

Background: Stroke can be a life-changing event, with survivors frequently experiencing some level of disability, reduced independence, and an abrupt lifestyle change. Not surprisingly, many stroke survivors report elevated levels of stress during the recovery process, which has been associated with worse outcomes.

Purpose: Given the multiple roles of stress in the etiology of stroke recovery outcomes, we aimed to scope the existing literature on stress management interventions that have been trialed in stroke survivors.

Methods: We performed a database search for intervention studies conducted in stroke survivors which reported the effects on stress, resilience, or coping outcome. Medline (OVID), Embase (OVID), CINAHL (EBSCO), Cochrane Library, and PsycInfo (OVID) were searched from database inception until March 11, 2019, and updated on September 1, 2020.

Results: Twenty-four studies met the inclusion criteria. There was significant variation in the range of trialed interventions, as well as the outcome measures used to assess stress. Overall, just over half (13/24) of the included studies reported a benefit in terms of stress reduction. Acceptability and feasibility were considered in 71% (17/24) and costs were considered in 17% (4/24) of studies. The management of stress was rarely linked to the prevention of symptoms of stress-related disorders. The overall evidence base of included studies is weak. However, an increase in the number of studies over time suggests a growing interest in this subject.

Conclusions: Further research is required to identify optimum stress management interventions in stroke survivors, including whether the management of stress can ameliorate the negative impacts of stress on health.

Keywords: Depression; Resilience; Stress; Stress intervention; Stress management; Stroke.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Counseling
Humans
Psychotherapy*
Stress, Psychological / psychology
Stress, Psychological / therapy
Stroke* / therapy
Survivors