Psychophysiological Effects of an Expressive Arts-based Intervention in Young and Pre-elderly Stroke Survivors: A Randomized Controlled Trial.

IF 3.6 2区 医学 Q1 REHABILITATION
Rainbow T H Ho, Temmy L T Lo, Ted C T Fong, Caitlin K P Chan, Marco Y C Pang, Adrian H Y Wan, Pamela P Y Leung, Gary K K Lau
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引用次数: 0

Abstract

Objective: To examine the psychophysiological effects of an 8-week expressive arts-based intervention (EABI) on young and pre-elderly stroke survivors.

Design: A parallel-group randomized controlled trial.

Setting: Public hospitals and community sites.

Participants: Community-dwelling participants (N=157) aged between 18 and 64 years who experienced a major stroke event in the past 10 years with mild to moderate post-stroke impairments (modified Rankin scale level=1-4).

Interventions: Participants were randomly assigned to an 8-week EABI group (N=75) once per week for 90 minutes or a treatment-as-usual waitlist control group (CG) (N=82).

Main outcome measures: Outcomes of psychophysiological functioning, including depression, anxiety, perceived social support, hope, self-esteem, generic and stroke-specific quality of life (QOL), and salivary cortisol, were measured at three assessment waves: baseline (T0), 2 months after baseline (T1), and 8 months after baseline (T2). The short-term (T0-T1) and long-term (T0-T2) effects of the EABI were analyzed by latent change analysis. Mediation analysis was conducted to explore the potential mechanisms of the short-term and long-term EABI effects.

Results: From T0 to T1, the EABI group showed significant improvements in perceived social support, hope, and self-esteem (Cohen d=0.32-0.48) compared with the CG. From T0 to T2, there were significant improvements in anxiety symptoms and self-esteem, physical QOLs, and wake-up cortisol (d=0.34-0.46). Short-term improvements in perceived social support and hope partially mediated the long-term EABI effects on physical QOLs. The beneficial effects of EABI showed heterogeneity across gender and stroke types.

Conclusions: This study found short-term effects for the EABI on perceived social support and hope and long-term effects on self-esteem and physiological functioning. Future research should develop tailored EABI as multifaceted support for rehabilitation practice for stroke survivors.

以表达艺术为基础的干预对年轻和老年中风幸存者的心理生理影响:一项随机对照试验。
目的:探讨为期8周的表达艺术干预(EABI)对年轻和老年前脑卒中幸存者的心理生理影响。设计:平行组随机对照试验设置:公立医院和社区站点参与者:社区居住的参与者(N=157),年龄在18至64岁之间,在过去10年内经历过一次重大中风事件,并伴有轻度至中度中风后损伤(修改Rankin量表水平 = 1-4)。干预措施:参与者被随机分配到一个为期8周的EABI组(N=75),每周一次,每次90分钟,或一个照常治疗的等待列表对照组(N= 82)。主要结果测量:心理生理功能的结果,包括抑郁、焦虑、感知社会支持、希望、自尊、一般和中风特异性生活质量(QOL)和唾液皮质醇,在三个评估波中测量:基线(T0)、基线后2个月(T1)和基线后8个月(T2)。采用潜在变化分析分析EABI的短期(T0 ~ T1)和长期(T0 ~ T2)效应。通过中介分析探讨短期和长期EABI效应的潜在机制。结果:从T0到T1,与CG相比,EABI组在感知社会支持、希望和自尊方面有显著改善(Cohen d = 0.32-0.48)。从T0到T2,焦虑症状和自尊、身体质量、唤醒皮质醇均有显著改善(d = 0.34-0.46)。感知社会支持和希望的短期改善部分介导了EABI对身体生活质量的长期影响。EABI的有益效果在性别和脑卒中类型中表现出异质性。结论:本研究发现EABI对感知社会支持和希望有短期影响,对自尊和生理功能有长期影响。未来的研究应该开发量身定制的EABI,作为中风幸存者康复实践的多方面支持。
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来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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