Exploring the Utility and Accessibility of non-pharmacological interventions for mood and emotion problems following stroke

Ottaway, Georgina (2023) Exploring the Utility and Accessibility of non-pharmacological interventions for mood and emotion problems following stroke. Doctoral thesis, University of East Anglia.

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Abstract

Background: Anxiety, depression, and emotionalism frequently arise following a stroke. Often, demographic and social factors can impact the accessibility and the helpfulness of interventions to support those with post-stroke mood conditions.

Aim: This thesis aimed to explore the reporting of protected characteristics known to impact health equity in non-pharmacological intervention research for post-stroke anxiety and/or depression to understand what characteristics are considered and analysed in research. Additionally, the thesis aimed to explore the contextual factors which can impact the accessibility and utility (helpfulness) of non-pharmacological interventions for post-stroke anxiety, depression, and/or emotionalism.

Method: Firstly, a systematic scoping review was conducted to investigate the reporting of protected characteristics in randomised controlled trials exploring the effectiveness of non-pharmacological interventions for post-stroke anxiety and/or depression. The review also aimed to highlight any studies which explored whether any differences in outcomes were identified based on participant’s protected characteristics. Secondly, an empirical paper aimed to identify the opinions of healthcare professionals and researchers on the helpfulness of post-stroke emotionalism (PSE) non-pharmacological interventions and understand the contextual factors that can impact the accessibility of interventions. The study aimed to reach a consensus regarding the helpfulness of these interventions using the Delphi Method and to explore the context regarding the barriers to accessibility by running mini-focus groups.

Results: The systematic scoping review identified that many protected characteristics are not included in RCTs focusing on post-stroke anxiety and/or depression. Furthermore, there is not enough research to suggest whether certain interventions may be accessible or helpful to certain groups based on their protected characteristics. In the empirical paper, providing education to the patient and family were found to be the most helpful interventions, whilst offering reassurance, asking the patient to take a deep breath, and acknowledging the PSE and then continuing with their current activity were identified as the most accessible. A content analysis of the mini-focus groups’ transcripts revealed two themes: “barriers to the accessibility of PSE non-pharmacological interventions” and “suggestions to manage barriers”.

Conclusion: This thesis portfolio highlights the need for research to consider reporting the protected characteristics of participants to support clinicians in their decision-making regarding use of non-pharmacological interventions to support people with post-stroke anxiety and depression. Furthermore, services should consider applying a person-centred approach when supporting those with PSE and consider whether a protocol needs to be created to identify who should be supporting those with PSE across the stroke pathway.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	07 Nov 2023 13:44
Last Modified:	07 Nov 2023 13:44
URI:	https://ueaeprints.uea.ac.uk/id/eprint/93592
DOI:

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