Anxiety after stroke: intervention design and a randomised controlled trial
Item statusRestricted Access
Embargo end date06/07/2020
Chun, Ho-Yan Yvonne
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INTRODUCTION: Anxiety is common and potentially debilitating after stroke. There is no reliable evidence to guide treatment. Barriers exist in accessing psychological care after stroke. Little is known about anxiety subtypes and what provokes anxiety in people after stroke. Treatment approaches effective in non-stroke populations may not be feasible or generalisable to stroke patients. AIMS: The first aim is to develop an intervention for treating anxiety after stroke and evaluate its feasibility in patients. The second aim is to test the feasibility of a randomised controlled trial (RCT) to evaluate the intervention’s effectiveness. METHODS: I used a range of clinical research methodologies: i) a systematic review to summarise the design of anxiety interventions in stroke and acquired brain injury and their efficacy; ii) a prospective cohort study to investigate the frequency of anxiety subtypes, anxiety-provoking stimuli, factors associated with anxiety, and clinical outcomes associated with anxiety after stroke; iii) a study of diagnostic validity and reliability of two anxiety measures, iv) complex intervention development using a systematic approach; v) a feasibility RCT—Treating Anxiety after StroKe (TASK RCT) RESULTS: My anxiety intervention was practical to deliver and acceptable to patients. The TASK RCT procedures were feasible at a small scale. This thesis will inform further refinements of the intervention and trial procedures in preparation for the large scale definitive TASK RCT.