The Effect Of A Brief Intervention For Patients With Ischemic Stroke: A Randomized Controlled Trial

Objectives: This study was designed to understand the depressive and anxious status aswell as the knowledge of stroke among ischemic stroke patients, and to evaluate theefficacy of an early and brief intervention—Neuro-Linguistic Programming (NLP) plushealth education in reducing depression and anxiety as well as improving the knowledge ofstroke for patients.Methods: A randomized controlled trial was conducted at a single hospital in Wuhan.One hundred eighty hospitalized stroke patients met the inclusion criteria were randomlyallocated to receive four sessions of NLP plus health education (n=90) or usual care (n=90).A set of questionnaires was used to collect data pre-and post-intervention as well as at thesix-month follow-up. The primary outcomes were the remission of depression and anxiety,and the awareness of stroke knowledge. Data was carried in EpiData3.0, and analyzed bySas9.2software.Results:(1) At baseline,58.3%of the participants had depressive symptoms and55.6%had anxious symptoms. There were no statistic differences in the extent of depression andanxiety between the intervention group and the control (P>0.05). Chi-square test founddifferences between groups in the remission of depression and anxiety immediately afterintervention (P<0.05), but no differences at the six-month follow-up (P>0.05). Logistic regression analysis showed that the intervention had a positive effect on the remission ofdepression and anxiety (OR=3.207and2.520, respectively), but no effect at the six-monthfollow-up. Generalized estimating equations (GEE) analysis showed that the intervenionwas overall effective in reducing the number of patients with depressive or anxioussymtoms (P<0.05). The effect began to manifest immediately after intervention, anddeclined at the follow-up. The baseline extent of depression and anxiety also influencedthese two outcomes (P<0.001).(2) The average awareness rate of stroke knowledge was27.6%(risk factors:32.6%;warning signs:21.9%). There were no statistic differences in each items (P>0.05) exceptone with marginally statistic difference (P=0.045). After intervention, the awareness ratesof stroke knowledge in the intervention group were better than the control group.(3) As to the secondary outcomes, the intervention group had better quality of life and lessdependence of daily living both after intervention and at the follow-up (P<0.05). There wasno difference in the severity of stroke between groups after intervention (P>0.05).Conclusions: The prevalence of depression and anxiety was high among ischemic strokepatients, and the awareness rate of stroke knowledge was very low. NLP plus healtheducation could reduce the prevalence of depression and anxiety immediately afterintervention, but not at the six-month follow-up. Moreover, the intervention could improvethe awareness of stroke knowledge, and benefit patients on quality of life and physicalfunction.