Tailoring Self-Help Mindfulness and Relaxation Techniques for Stroke Survivors: Examining Preferences, Feasibility and Acceptability

Abstract

Objective: Studies on psychological techniques to reduce stroke-related anxiety and/or distress are limited. More scarce is research on tailoring such techniques to suit stroke survivors’ needs, including the needs of those with aphasia. To address this gap, we report two sequential studies. Study 1 explored preferred psychological techniques (i.e., mindfulness and relaxation) and ways to modify them for stroke survivors, including those with communication difficulties. Study 2 examined the feasibility and acceptability of these modified techniques with a new sample of survivors. Design: Mixed-methods using qualitative and quantitative approach in both studies. Participants: All participants were stroke survivors living in the community (Study 1: n = 13, median age = 61 years; Study 2: n = 38, median age = 67 years). Interventions and Procedures: Study 1: seven techniques representing commonly used types of mindfulness and relaxation were filmed on a professionally produced DVD. Participants feedback on how these techniques could be tailored to meet their needs, their preferences for techniques and reasons for likes and dislikes. Study 2: four favored techniques from study 1 were modified and re-filmed into a new DVD. A new group of participants were asked to practice them twice daily, five times a week for at least 4 weeks. They completed questionnaires at the start of the study (T1), returned approximately 4 weeks later completing the same measures ( n = 24 at T2). Focus group discussions/interviews were conducted at the end of T2 exploring the feasibility and acceptability of these techniques. Results: Four techniques were favored by participants in Study 1. After adaptation, these techniques were generally perceived as acceptable, user-friendly and beneficial to participants who participated in the focus groups /interviews in Study 2. A ‘once a day’ practice frequency could make practicing more feasible. Participants also preferred having choices- multiple techniques could be more useful than single technique. Conclusion: Tailoring psychological techniques for stroke survivors is beneficial. Tailored techniques in a self-help DVD format seemed feasible and acceptable, however, a less frequent practice would be easier for stroke survivors. Future studies should seek to recruit a more heterogenous sample as well as implementing strategies to increase the retention rate.

Randomized control trial evidence for the benefits of massage and relaxation therapy on sleep in cancer survivors—a systematic review

“…The lack of ongoing face-to-face or telephone support of these programs by psychologists or psychiatrists and the resultant inability to tailor the relaxation therapy techniques to the individual participants' requirements and preferences may have been some of the reasons for the relatively poor adherence and lack of significant improvements in sleep outcomes. Such views appear consistent with the wider literature on the barriers to the successful and effective utilization of relaxation therapy in clinical populations [36,37]. Therefore, among the 7 RCTs examined, there appeared to be more support for massage therapy than relaxation therapy for improving sleep outcomes in cancer survivors.…”

Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications

“…A systematic review revealed that mind-body interventions ( i.e ., yoga, Tai Chi) may have potential benefits for treating both PSA and PSD by improving the mood and quality of life of stroke survivors[ 66 ]. Likewise, self-help mindfulness and relaxation techniques have been reported to be effective self-administered therapies to help alleviate symptoms, especially for patients with communication difficulties[ 67 ]. This suggests that PSA subtypes[ 62 ] and tailored therapeutic strategies are vital for future interventional studies.…”

A Feasibility Study of a One-to-One Mindfulness-Based Intervention for Improving Mood in Stroke Survivors

“…However, participants suggested they would prefer shorter sessions and an initial orientation if embarking on a full course of MBSR. Wang et al (2019b), using data from focus group discussions, reported that an intervention comprising mindfulness exercises recorded on DVD was acceptable to participants, although the authors noted that less than two-thirds of participants (24/38) were retained at postintervention follow-up. Neither of these feasibility studies with stroke survivors was focused on participants with depression and/or anxiety as assessed at baseline.…”