Assessing the Acceptability and Feasibility of Adapted Cognitive Stimulation Therapy for Stroke (sCST) using the ADePT Framework

Bramley, Maximilian (2025) Assessing the Acceptability and Feasibility of Adapted Cognitive Stimulation Therapy for Stroke (sCST) using the ADePT Framework. Doctoral thesis, University of East Anglia.

Preview

PDF Download (5MB) | Preview

Abstract

Background: Informal stroke caregivers are often important in rehabilitation and management of disability following stroke. Dyadic interventions have demonstrated wellbeing gains for caregivers and functional gains for stroke survivors, but dyadic cognitive interventions are rare.

Aim: Develop an understanding of the acceptability, feasibility and benefits of dyadic cognitive interventions after stroke, particularly for stroke caregivers.

Method: A systematic review of dyadic interventions that assessed post-stroke cognition and caregiver wellbeing outcomes, was conducted to identify the measures used, if and how cognition was targeted and caregivers involved, and evidence of psychosocial gains for informal caregivers. An empirical paper explored pre-frail stroke caregiver acceptability of a pilot sCST (stroke Cognitive Stimulation Therapy) intervention that encouraged caregiver participation using Framework Analysis. A second empirical paper used ‘A process for Decision-making after Pilot and feasibility Trials’ (ADePT) to facilitate decision making and appraise solutions for feasibility and acceptability limitations identified through the pilot.

Results: The systematic review, highlighted the most prevalent cognitive and wellbeing measures for stroke survivors and their caregivers. One cognitive trial actively inviting the participation of both in the dyad found significant gains in caregiver wellbeing. Four participants completed sCST, all caregivers reported it increased the insight of dyads in addition to anticipated or current psychosocial gains, and while 75% of caregivers would attend further sessions if at a different location, practical and emotional burdens affected acceptability. The ADePT paper suggested sCST strengths in feasibility and acceptability for dyads but the a priori recruitment target was not reached, logistic and psychosocial factors limited the acceptability of sCST for some dyads.

Conclusions: The findings of the portfolio highlight the importance of caregiver inclusion in cognitive interventions for stroke survivor dyads and pre-frail stroke survivor dyads and factors to consider when piloting these interventions.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	21 Oct 2025 09:00
Last Modified:	21 Oct 2025 09:00
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100729
DOI:

Downloads

Actions (login required)

View Item