Effects of a nurse-led therapeutic conversations intervention in stroke patient-family caregiver dyads: A randomized control trial

BackgroundFew studies have evaluated the effectiveness of family functional care interventions among stroke caregiver dyads. This study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and quality of life (QoL) in stroke family caregiver dyads.AimsThis study aimed to examine the effect of a nurse-led therapeutic conversation intervention on resilience, family function, self-efficacy in managing the disease, and QoL in stroke-family caregiver dyads.DesignThis study was a single-blind (evaluator) randomized controlled trial. The planned execution time was from August 2021 to December 2022, in the rehabilitation ward of a medical university hospital.MethodsA total of 82 dyads were included in this analysis. Dyads randomized to the intervention group received nurse-led therapeutic conversations intervention one at four weeks after the patient's hospitalization for a stroke. The family caregiver dyads of stroke survivors in the control group received routine care. An effectiveness analysis that included patients' resilience, self-efficacy, and patient-family caregiver dyads' family function and QoL was conducted at one month. We used the CONSORT Checklist for reporting parallel group randomized trials in this study.ResultsThe patients in the intervention group showed improvement in resilience and self-efficacy after one month. Furthermore, the effects on resilience (Cohen's d = 0.49) and self-efficacy (Cohen's d = 0.46) were significantly higher than in the control group. Family functioning was significantly higher in patient-family caregiver dyads in the intervention group than in the control group (Cohen's d = 0.55; Cohen's d = 0.50). However, no significant difference in QoL was found between patients and caregivers in either group.ConclusionsThe intervention was effective in promoting family functioning and can also promote patient resilience and self-efficacy in disease management. However, the intervention did not have a significant effect on the QoL of patient-family caregiver dyads. What is already known about this topic? Many interventional care treatments ignore the important psychological factors involved in caring for patients with stroke. Family nursing actions through conversations between nurses and patients/families are helpful for families dealing with the challenges and complex experiences of a patient's illness.What this paper adds? The present study demonstrated that a nurse-led therapeutic conversation intervention could promote family functioning among patients and family caregivers. Nurse-led therapeutic interventions can also promote patients' resilience and self-efficacy in managing the disease. However, the therapeutic conversation intervention did not have a significant effect on the quality of life of the patient-family caregiver dyads.Implications of this study It is recommended to corroborate a nurse-led therapeutic conversation intervention as a strength-oriented family intervention in stroke rehabilitation practice. Nurses can identify the care requirements of patients and their family caregivers through therapeutic conversations and offer personalized care solutions. Nurse-led therapeutic conversation interventions can be implemented in patient empowerment strategies, emphasizing its effectiveness in boosting patient resilience and self-efficacy in disease management.