Why is this research needed?
Depression is a common effect of stroke and 33% of survivors have depression one year after their stroke. It’s linked to worse recovery and increased hardship for carers, use of healthcare services, and the likelihood of death.
We don’t have good enough treatment for depression after stroke. Across 10 UK stroke services for mood and emotional problems, it was found that most stroke survivors received monitoring and advice, with less than half of the patients with low mood receiving treatments.
Aphasia is a communication problem that is common after a stroke. It can make it even harder for stroke survivors to get the support they need to cope with mood and emotional problems, including depression. This is true both for support from stroke services and their social networks, such as friends and family.
There is an urgent need for research into treatments that can help mood, emotional and social wellbeing for people with stroke and aphasia.
What do the researchers hope to do?
This project aims to find out if peer support can help stop people with aphasia from getting severe mood problems.
They will do this by:
- Understanding how people with aphasia and those close to them adjust to life after stroke.
- Exploring how to effectively run a peer-befriending scheme and what benefits it may have for people with aphasia.
Sixty people with stroke and aphasia will be recruited and all of them will receive the usual care offered by their local stroke service. Half will be selected randomly to also receive support from a peer befriender.
Ten persons with long-term aphasia after stroke will be trained as peer befrienders. They will be paired with people who have aphasia after a more recent stroke. The befriender will start visiting their peer stroke survivor soon after they're discharged from the hospital and will aim to visit them six times.
Stroke survivors will complete questionnaires on mood, well-being, and participation several times during the study. Their significant others, such as spouses, will also complete questionnaires. This will show whether those who are close to them also feel the benefits of peer befriending.
Stroke survivors and significant others will also be interviewed to understand their experiences.
The views of peer befrienders will also be explored through completing questionnaires and by interviewing them.
- Understanding if it’s possible to calculate the economic benefits of peer befriending as a treatment.
Costs of usual care and peer befriending will be calculated (economic evaluation) to identify the added value of this treatment.
What happened?
This research was successful, with 56 people with aphasia, 48 significant others and 10 peer befrienders taking part.
The research found out what can help stroke survivors with aphasia adjust to their life after stroke, including the role of healthcare professionals.
This video tells you more about these findings:
The researchers found that:
- It’s possible to get peer befrienders, recent stroke survivors and those close to them to take part in the study and stick to the plans for treatment.
- Stroke survivors with aphasia who were paired with a peer befriender were less likely to have low mood.
- Peer befriending is viewed positively and is safe.
- It’s possible to collect information that will allow researchers to measure the cost-benefit of the treatment in the future.
This video tells you more about these findings:
This research also improves our understanding of why peer befriending can be a successful treatment, this includes:
- Why peer befriending may be helpful to the befrienders, recent stroke survivors with aphasia and those close to them.
- What can be done to help make peer befriending a successful treatment for stroke survivors with aphasia.
This video tells you more about these findings:
Ivy who has had a stroke and her daughter took part in the research. Her daughter said “[Befrienders] are experts. They have been through the same path, so they are the best people to talk to. It gives you the confidence and hope that people have been through it that you can also go through it and be perfect, it’s not the end of life.”
What difference did this research make to people affected by stroke?
This research shows that it’s possible, and may be beneficial to offer peer befriending as a treatment to help stop stroke survivors with aphasia from getting mood and emotional problems, and improve their participation in activities. The study suggests that peer befriending should be tested further in more stroke survivors and in more settings to see if it could one day be offered as routine care.
You can find out more on the research project website.
This is a Stroke Association Priority Programme Award.
(Left to right: Lady Wolfson, Dr Katerina Hilari and Professor Sir Mark Walport)