Wellbeing After Stroke (WAterS): feasibility testing of a co-developed Acceptance and Commitment Therapy (ACT) intervention, to support psychological adjustment after stroke

Abstract

ObjectiveFeasibility test a co-developed intervention based on Acceptance and Commitment Therapy (ACT) to support psychological adjustment post-stroke, delivered by a workforce with community in-reach.DesignObservational feasibility study utilising Patient, Carer, Public Involvement (PCPI).SettingOnline. UK.ParticipantsStroke survivors with self-reported psychological distress 4+ months post-strokeInterventionsThe co-developed Wellbeing After Stroke (WAterS) intervention includes: nine weekly, structured, online, group sessions for stroke survivors, delivered via a training programme to upskill staff without previous ACT experience, under Clinical Psychology supervision.Main measuresFeasibility of recruitment and retention; data quality from candidate measures; safety. Clinical and demographic information at baseline; Patient Reported Outcome Measures (PROMs) via online surveys (baseline, pre- and post-intervention, 3 and 6 months after intervention end) including Mood (HADS), Wellbeing (ONS4), Health-Related Quality of Life (EQ5D5L), Psychological Flexibility (AAQ-ABI) and Values-Based Living (VQ).ResultsWe trained eight staff and recruited 17 stroke survivors with mild-to-moderate cognitive and communication difficulties. 12/17 (71%) joined three intervention groups with 98% attendance and no related adverse events. PROMS data were well-completed. The HADS is a possible future primary outcome (self-reported depression lower on average by 1.3 points: 8.5 pre-group to 7.1 at 3 month follow up; 95% CI 0.4 to 3.2).ConclusionThe WAterS intervention warrants further research evaluation. Staff can be trained and upskilled to deliver. It appears safe and feasible to deliver online to groups, and study recruitment and data collection are feasible. Funding has been secured to further develop the intervention, considering implementation and health equality.