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Psychological distress including depression and anxiety is a major component of caregiver stress, and its negative impact on caregivers' health and well-being has been established in the literature. A recent meta-analysis reported the prevalence of depression and anxiety in stroke caregivers as 40.2% and 21.4% respectively.
An evidence profile report by the World Health Organization(WHO) has emphasised that psychological support is crucial in helping caregivers in the community to continue caring for individuals with long-term disabilities, such as stroke patients. Therefore, early psychological intervention (EPI) is crucial to improve the management and prognosis of an individual who are facing stressful events like caregiving.
The main aim of this study is to prevent or alleviate the significant psychological consequences in carers resulting from stroke events in family members. Internet-delivered cognitive-behavioural therapy (iCBT) is delivered as an ecological momentary intervention (EMI) to support the clients to engage in cognitive reframing and empower them with proper knowledge, skills and attitudes to make behavioural changes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | Receive iCBT-based EMI with message content, delivery frequency and timing personalised to participants' preferences. |
|
| Control Group | No Intervention | Receive general mental health information through instant message. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| iCBT-based EMI | Behavioral | Consists of brief iCBT for psychological support (mandatory), stroke care education (optional), and nurse-led real-time chat-based support messages, delivered according to participants' preferences. |
| Measure | Description | Time Frame |
|---|---|---|
| Depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) | A 9-item scale with score ranging from 0 to 27, higher scores indicate higher severity of depressive symptom | 24-week |
| Measure | Description | Time Frame |
|---|---|---|
| Anxiety symptoms (Generalized Anxiety Disorder-7 [GAD-7]) | A 7-item scale with score ranging from 0 to 21, higher scores indicate higher severity of anxiety symptoms | 24-week |
| Stress level (Perceived Stress Scale [PSS-4]) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jung Jae LEE | Contact | +852 3917 6971 | leejay@hku.hk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kwong Wah Hospital | Not yet recruiting | Hong Kong | Hong Kong |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D000084802 | Caregiver Burden |
| D000075782 | Cell Phone Use |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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A 4-item scale with score ranging from 0 to 16, higher scores indicate higher severity of stress
| 24-week |
| Loneliness level (UCLA Loneliness Scale [ULS-8]) | The total score (8 items) ranges from 8 to 32 points, with higher scores suggesting a higher degree of loneliness | 24-week |
| Acceptance and Action Questionnaire-II (AAQ-II) | The total score (7 items) ranges from 7 to 49 points, with higher scores suggesting a higher degree of psychological inflexibility and experiential avoidance | 24-week |
| Princess Margaret Hospital | Recruiting | Hong Kong | Hong Kong |
|
| Queen Elizabeth Hospital | Recruiting | Hong Kong | Hong Kong |
|
| Queen Mary Hospital | Recruiting | Hong Kong | Hong Kong |
|
| United Christian Hospital | Recruiting | Hong Kong | Hong Kong |
|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D013315 | Stress, Psychological |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D003142 | Communication |
| D012919 | Social Behavior |