Post-traumatic headache is one of the most common symptoms following mild and moderate head injury. Psychological factors are believed to play a role in the cause, maintenance and relief from chronic post-traumatic headache. This research evaluated the effectiveness of a multi-dimensional cognitive-behavioural approach towards rehabilitation of post-traumatic headaches. The sample included 20 participants with post-traumatic headaches from an original sample of 41. Participants acted as their own controls. Outcome measures consisted of self-rating questionnaires to assess headache severity, intensity, duration, functioning and emotional well-being. Emotional and functional headache characteristics were studied using a multi-dimensional investigation which included relatives' perceptions of the sufferers headaches. The intervention proved effective and beneficial for the 20 therapy participants. It is concluded that cognitive-behavioural therapy provides a useful supplement to the treatment of post-traumatic headache.

Effective communication between health professionals and patients is fundamental to achieving high-quality care. In addition to improving patient satisfaction and subjective wellbeing, effective nurse–patient communication is understood to directly influence patients' health outcomes. Following a stroke, good communication can be particularly challenging. Nurses and care staff require strong communication skills to be able to adapt flexibly to patients' needs and abilities. Given the resource-strapped nature of the NHS and high staff turnover, traditional, lengthy training in communication is neither economical nor practical. This report reviews an innovative, brief communication training session provided to 31 care staff working with patients who had recently had a stroke. This training comprised a short education session in the clinical environment (a hospital ward) and solution-focused reflection. Overall findings indicate that the training was acceptable to nurses and care staff and it improved their confidence in communicating with patients. Limitations include a lack of behavioural measurement of changes in such nurse–patient communications.

Aims This article discusses the implementation and evaluation of a psychosocial group for stroke survivors in the acute phase of rehabilitation. Participants were encouraged to share thoughts and feelings about the impact of their stroke, progress in rehabilitation, and views on the future. It was hoped that this intervention would help patients' emotional adjustment to difficulties following stroke. The evaluation aimed to discover how successful the group was in achieving this. Methods Participants' emotional functioning was measured using the Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983), and showed no significant changes in mood following the group. A trend towards improvement in mood was indicated by the reduction of mean HADS scores at the end of the intervention. Participants' contributions during the group sessions were recorded on flipcharts. Participants were asked to rate, on a 10-point Likert-rating item, how helpful for recovery they found the group. Findings The categorization of participants' contributions revealed eight themes in their attitude to stroke problems. While the evaluation did not show that the group caused a significant improvement in participants' moods, the majority reported on the 10-point Likert-rating item that the group was helpful for the recovery process (average score 7). Conclusions A longer intervention with larger numbers of participants would be necessary to assess whether the group could improve mood. However, even with this brief trial, participants found it very helpful, and the group leaders reported that they gained a better understanding of participants' individual ways of dealing with difficulties, and that this intervention contributed to improved team working.

The study highlights the importance of mood assessments for all stroke patients. The percentage of patients with residual psychological problems was lower than that reported in the literature. However, it is highly recommended for those patients with chronic poststroke psychological distress to have access to specialist psychological interventions.

Aims/Background: The outcomes of cognitive assessments after stroke provide important information for the implementation of immediate specialist interventions. This study investigated the trajectory of cognitive changes in an acute stroke sample. This was done by examining the relationship between cognitive changes following stroke as determined by the Montreal Cognitive Assessment (MoCA) and patients' discharge locations (own home, home with social care package, and placement). Method: The data of 124 hospitalised patients with acute stroke was retrospectively analysed. Patients' age ranged from 51 to 96 years, 77 patients were women and 47 were men. Data of post-stroke cognitive outcomes as represented by the MoCA results and discharge location were collected. Results: Patients' MoCA Mean outcome was 12.12 and Standard Deviation 7.77. Significant differences were found between patients with low post-stroke cognitive functioning, requiring more intensive care after discharge (i.e. placement), and those with better cognition, who subsequently were discharged home. The MoCA subdomain ‘Concentration and Calculation’ was associated most with discharge location. The study outcomes can potentially improve the efficiency of very early interventions and hospital discharge plans for acute stroke patients.