INTERVENCIONES EDUCATIVAS PARA FORMAR A CUIDADORES DE SUPERVIVIENTES DE ACV: REVISIÓN DEL ALCANCE

Costa, Francine Melo da; Canto, Débora Francisco do; Felipe, Laís Thiele; Rosset, Idiane; Paskulin, Lisiane Manganelli Girardi

Francine Melo da Costa

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Final review and approval of the final version

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0003-3390-2601

Débora Francisco do Canto

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Final review and approval of the final version

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0001-9054-0876

Laís Thiele Felipe

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Final review and approval of the final version

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0009-0007-9307-0698

Idiane Rosset

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Final review and approval of the final version

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0003-3651-652X

Lisiane Manganelli Girardi Paskulin

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Final review and approval of the final version

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Programa de Pós-graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0003-1444-4086

CORRESPONDING AUTHOR
Débora Francisco do Canto. dcanto@hcpa.edu.br

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Gisele Cristina Manfrini, Ana Izabel Jatobá de Souza.

Editor-in-chief: Elisiane Lorenzini.

Database	Search strategy
MEDLINE/PubMed	(intervention OR intervenção) AND (stroke OR “acidente vascular cerebral”) AND (skills OR preparedness OR knowledge OR habilidades OR capacidade OR conhecimento) AND (“informal caregivers” OR “family caregivers” OR “cuidadores familiares” OR “cuidadores informais”)
WoS	(intervention OR intervenção) AND (stroke OR “acidente vascular cerebral”) AND (skills OR preparedness OR knowledge OR habilidades OR capacidade OR conhecimento) AND (“informal caregivers” OR “family caregivers” OR “cuidadores familiares” OR “cuidadores informais”)
SciELO	(intervention OR intervenção) AND (stroke OR acidente vascular cerebral) AND (caregivers OR cuidadores)
CINAHL	(intervention OR intervenção) AND (stroke OR “acidente vascular cerebral”) AND (skills OR preparedness OR knowledge OR habilidades OR capacidade OR conhecimento) AND (“informal caregivers” OR “family caregivers” OR “cuidadores familiares” OR “cuidadores informais”)

Study/country/ level of evidence*	Objectives	Conclusions	Study design/participants	Findings
Lin et al. (2022)1313.Lin S, Xiao LD, Chamberlain D, Ullah S, Wang Y, Shen Y, et al. Nurse-led health coaching programme to improve hospital-to-home transitional care for stroke survivors: A randomised controlled trial. Patient Educ Couns [Internet]. 2022 [cited 2024 Jan 15];105(4):917-25. Available from: https://doi.org//10.1016/j.pec.2021.07.020 . https://doi.org//10.1016/j.pec.2021.07.0... /China/ 1.c	Assess the effects of a nurse-led health coaching program for stroke survivors^† and family caregivers during the hospital to home transition.	Survivor self-efficacy and QoL^‡; caregiver burden	RCT^§/140 dyads (stroke survivors^† and family caregivers)	Improved health outcomes for stroke survivors^† and their caregivers.
Elsheikh et al. (2022)2020.Elsheikh MA, Moriyama M, Rahman MM, Kako M, EL-Monshed AH, Zoromba M, et al. Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: A randomised controlled trial. BMJ Open [Internet]. 2022 [cited 2024 Jan 10];12(2):e049741. Available from: https://doi.org//10.1136/bmjopen-2021-049741 . https://doi.org//10.1136/bmjopen-2021-04... /Egypt/ 1.c	Assess the effectiveness of a multidimensional intervention in reducing the burden of family caregivers of stroke survivors^†.	Caregiver burden	RCT^§/110 caregivers	Participants in the intervention group^\|\| (IG) showed no improvement in the main outcomes.
Silva e Boery (2021)1111.Silva JK, Boery RNSO. Effectiveness of a support intervention for family caregivers and stroke survivors. Rev Latino-Am Enferm [Internet]. 2021 [cited 2024 Jan 15];29:e3482. Available from: https://doi.org /10.1590/1518-8345.4991.3482 . https://doi.org /10.1590/1518-8345.4991.... /Brazil/ 2.c	Analyze the effectiveness of a supportive intervention on family caregiver burden and stress and on stroke survivor^† degree of independence.	Caregiver burden	Quasi-experimental/37 caregivers	Reduced family caregiver burden and stress.
Day et al. (2021)1919.Day CB, Bierhals CCBK, Mocellin D, Predebon ML, Santos NO, Dal Pizzol FLF, et al. Nursing Home Care Intervention Post Stroke (SHARE) 1 year effect on the burden of family caregivers for older adults in Brazil: A randomized controlled trial. Health Soc Care Community [Internet]. 2021 [cited 2024 Jan 15];29(1):56-65. Available from: https://doi.org 10.1111/hsc.13068 . https://doi.org 10.1111/hsc.13068... /Brazil/ 1.c	Assess the effect of a home nursing intervention on the burden of family caregivers of older adults who are stroke survivors^†.	Caregiver burden and QoL^‡	RCT^§/48 family caregivers	Positive effect on burden in the “Isolation” domain.
Gok Ugur e Erci (2019)66.Gok Ugur H, Erci B. The effect of home care for stroke patients and education of caregivers on the caregiver burden and quality of life. Acta Clin Croat [Internet]. 2019 [cited 2024 Jan 10];58(2):321-32. Available from: https://doi.org//10.20471/acc.2019.58.02.16 . https://doi.org//10.20471/acc.2019.58.02... /Turkey/ 2.c	Determine the effect of home care and education provided to post-stroke patients^† and their caregivers on caregiver burden and QoL^‡.	Caregiver burden and QoL^‡	Quasi-experimental/86 dyads	Reduced caregiver burden and increased their QoL^‡.
Zhang, Zhang e Sun (2019)55.Zhang L, Zhang T, Sun Y. A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke. Braz J Med Biol Res [Internet. 2019 [cited 2024 Jan 15];52(9):e8533. Available from: https://doi.org/10.1590/1414-431X20198533 . https://doi.org/10.1590/1414-431X2019853... /China/ 1.c	Assess the effect of an intensive caregiver education program in reducing cognitive impairment, anxiety, and depression in post-stroke patients^†.	Cognitive impairment, anxiety and depression in stroke survivors^†	RCT^§/196 stroke survivors†	Effectively reduced cognitive impairment, anxiety and depression.
Araújo (2018)1212.Araujo O, Lage I, Cabrita J, Teixeira L. Training informal caregivers to care for older people afterstroke: A quasi-experimental study. J Adv Nurs [Internet]. 2018 [cited 2024 Jan 10];74(9):2196-206. Available from: https://doi.org/10.1111/jan.13714 . https://doi.org/10.1111/jan.13714... /Portugal/2.c	Assess whether training in practical skills in caregiving reduces burden and improves the general health status of informal caregivers of older adults who have survived stroke^†.	Caregiver empowerment and burden	Quasi-experimental/174 informal caregivers	Better outcomes in caregiving skills and lower levels of burden.
Bakas et al. (2015)2121.Bakas T, Austin JK, Habermann B, Jessup NM, McLennon SM, Mitchell PH, et al. Telephone assessment and skill-building kit for stroke caregivers a randomized controlled clinical trial home. Stroke [Internet]. 2015 [cited 2024 Jan 10];46(12):3478-87. Available from: https://doi.org//10.1161/STROKEAHA.115.011099 . https://doi.org//10.1161/STROKEAHA.115.0... /USA/ 1.c	Assess the effectiveness of the Telephone Assessment and Skill-Building Kit (TASK II), a nurse-led intervention that enables caregivers to build skills based on their own needs assessment.	Depressive symptoms, life changes, and unhealthy caregiver days	RCT^§/254 caregivers	Reduced depressive symptoms and improved life changes for caregivers with severe depressive symptoms.
Pfeiffer et al. (2014)1414.Pfeiffer K, Beische D, Hautzinger M, Berry JW, Wengert J, Hoffrichter R, et al. Telephone-based problem-solving intervention for family caregivers of stroke survivors: A randomized controlled trial. J Consult Clin Psychol [Internet]. 2014 [cited 2024 Jan 15];82(4):628-43. Available from: https://doi.org//10.1037/a0036987 . https://doi.org//10.1037/a0036987... /Germany/ 1.c	Examine the effectiveness of a Problem-Solving Intervention (PSI) for caregivers of stroke survivors† who have been providing care for at least six months and are experiencing burden.	Depressive symptoms and caregiver empowerment	RCT^§/122 family caregivers	The PSI group showed lower levels of depressive symptoms, but not better perceived competence for caregiving.
Foster et al. (2013)1818.Forster A, Dickerson J, Young J, Patel A, Kalra L, Nixon J, et al. A structured training programme for caregivers of inpatients after stroke (TRACKS): A cluster randomised controlled trial and cost-effectiveness analysis. Lancet [Internet]. 2013 [cited 2024 Jan 10];382(9910):2069-76. Available from: https://doi.org/10.1016/s0140-6736(13)61603-7 . https://doi.org/10.1016/s0140-6736(13)61... /England/1.c	Investigate the physical and psychological outcomes and cost-effectiveness of the London Stroke Carers Training Course (LSCTC) for caregivers for stroke patients^† and caregivers.	Caregiver burden and stroke survivor functioning^†	RCT^§/928 dyads	No differences were evident between IG^\|\| and control group (CG)^¶.
Kim et al. (2012)1515.Kim SS, Kim EJ, Cheon JY, Chung SK, Moon S, Moon KH. The effectiveness of home-based individual tele-care intervention for stroke caregivers in South Korea. Int Nurs Rev [Internet] . 2021 [cited 2024 Jan 10];59(3):369-75. Available from: https://doi.org/10.1111/j.1466-7657.2011.00967.x . https://doi.org/10.1111/j.1466-7657.2011... /South Korea/ 2.c	Develop and assess the effectiveness of a hospital-based group intervention program and individual home-based telecare to reduce burden for family caregivers of stroke patients^†.	Caregiver burden	Quasi-experimental/73 family caregivers	The intervention was cost-effective and reduced family caregiver burden.
Perrin et al. (2010)1616.Perrin PB, Johnston A, Vogel B, Heesacker M, Vega-Trujillo M, Anderson J, et al. A culturally sensitive transition assistance program for stroke caregivers: Examining caregiver mental health and stroke rehabilitation. J Rehabil Res Dev [Internet] . 2010 [cited 2024 Jan 10];47(7):605-17. Available from: https://doi.org/10.1682/JRRD.2009.10.0170 . https://doi.org/10.1682/JRRD.2009.10.017... /USA/ 1.c	Develop and implement the Transition Assistance Program (TAP) for caregivers of people with stroke^†.	Caregiver burden and depression	RCT^§/61 dyads	It reduced caregiver burden and depression and improved stroke survivors’ functional capacity^†.
Shyu et al. (2010)2222.Shyu YL, Kuo L, Chen M, Chen S. A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan. J Clin Nurs [Internet]. 2010 [cited 2024 Jan 10];19(11-12):1675-85. Available from: https://doi.org/10.1111/j.1365-2702.2009.03124.x . https://doi.org/10.1111/j.1365-2702.2009... /Taiwan/ 1.c	Explore the long-term effects of a discharge preparation program for family caregivers of older stroke patients^†.	Caregiver empowerment	Experimental/158 dyads	The intervention improved the quality of care provided by caregivers and decreased the likelihood of survivors’ institutionalization.
Mou, Lam, Chian (2023)2323.Mou H, Lam SKK, Chien WT. The effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: A randomised controlled trial. Int J Nurs Stud [Internet]. 2023 [cited 2024 Jan 10];143:104504. Available from: https://doi.org/10.1016/j.ijnurstu.2023.104504 . https://doi.org/10.1016/j.ijnurstu.2023.... /China/ 1.c	Examine the effects of family-focused dyadic psychoeducational intervention (FDPEI).	Stroke survivor functioning; caregiver burden and competence	RCT^§/162 dyads	Significant reduction in burden and improvement in competence to care. Non-significant effects on stroke survivor functioning^†.
Bierhals et al. (2023)2424.Bierhals CCBK, Dal Pizzol FLF, Low G, Day CB, Santos NO, Paskulin LMG. Quality of life in caregivers of aged stroke survivors in southern Brazil: A randomized clinical trial. Rev Latino-Am Enferm [Internet]. 2023 [cited 2024 Jan 15];31:e3657. Available from: https://doi.org/10.1590/1518-8345.5935.3657 . https://doi.org/10.1590/1518-8345.5935.3... /Brazil/ 1.c	Assess the effect of home-based nursing educational intervention on the QoL^‡ of family caregivers of older adults who survived^†.	Caregivers’ and survivors’ QoL^‡	RCT^§/48 family caregivers	Statistically significant effect on family caregivers’ QoL^‡ in social relationships and autonomy, but not on overall QoL^‡.
Eames (2013)2525.Eames S, Hoffmann T, Worrall L, Read S, Wong A. Randomised controlled trial of an education and support package for stroke patients and their carers. BMJ Open [Internet]. 2013 [cited 2024 Jan 10];3:e002538. Available from: https://doi.org/10.1136/bmjopen-2012-002538 . https://doi.org/10.1136/bmjopen-2012-002... /Australia/ 1.c	Assess the effects of an educational package stroke patients’^† and caregivers’ knowledge, health, and psychosocial outcomes.	Knowledge, self-efficacy, anxiety, depression, satisfaction with information and caregiver burden; patient QoL^‡	RCT^§/138 participants (stroke survivors^† and caregivers)	IG^\|\| had greater self-efficacy to access information about stroke^† and satisfaction with the information.
Lelaurin (2021)2626.LeLaurin JH, Lamba AH, Eliazar-Macke ND, Schmitzberger MK, Freytes IM, Dang S, et al. Postdischarge Intervention for stroke caregivers: Protocol for a randomized controlled trial. JMIR Res Protoc [Internet]. 2020 [cited 2024 Jan 15];9(11):e21799. Available from: https://doi.org/ 10.2196/21799 . https://doi.org/ 10.2196/21799... /USA/ 1.c	Assess the feasibility and acceptability of internet-based and telephone-based support and problem-solving intervention - The Resources and Education for Stroke Caregivers’ Understanding and Empowerment (RESCUE) - for caregivers of stroke survivors^†.	Recruitment, retention, acceptability, depressive symptoms and caregiver burden	RCT^§/pilot study/53 caregivers	The results indicated that the intervention is feasible and acceptable to caregivers.
Mclennon (2016)2727.McLennon SM, Hancock RD, Redelman K, Scarton LJ, Riley E, Sweeney B, et al. Comparing treatment fidelity between study arms of a randomized controlled clinical trial for stroke family caregivers. Clin Rehabil [Internet]. 2016 [cited 2024 Jan 10];30(5):495-507. Available from: https://doi.org/0.1177/0269215515585134 . https://doi.org/0.1177/0269215515585134... /USA/ 1.c	Compare treatment fidelity between the TASK II and Information, Support, and Referral (ISR) intervention arms.	Adherence to the protocol, intervention dosage, interventionist nurse perspectives	RCT^§/254 caregivers of people with stroke^†	The findings support treatment fidelity in both arms of the study.
Pitthayapong (2017)2828.Pitthayapong S, Thiangtam W, Powwattana A, Leelacharas S, Waters CM. A community based program for family caregivers for post stroke survivors in Thailand. Asian Nurs Res [Internet]. 2017 [cited 2024 Jan 15];11(2):150e157. Available from:Available from: https://doi.org/10.1016/j.anr.2017.05.009 . https://doi.org/10.1016/j.anr.2017.05.0... /Thailand/ 2.c	Assess the effectiveness of a post-stroke care program^† within the community setting.	Caregiver care skills, functional capacity and health complications of stroke survivors^†	Quasi-experimental/62 dyads	Improved family caregivers’ caregiving skills, improved functional status, and decreased complications among post-stroke patients^†.
Azizi (2020)2929.Azizi A, Khatiban M, Mollai Z, Mohammadi Y. Effect of informational support on anxiety in family caregivers of patients with hemiplegic stroke. J Stroke Cerebrovasc Dis [Internet]. 2020 [cited 2024 Jan 10];29(9):105020. Available from: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105020 . https://doi.org/10.1016/j.jstrokecerebro... /Iran/ 2.c	Assess the effectiveness of an informational support intervention on the level of anxiety of family caregivers of hemiplegic stroke patients^†.	Caregiver anxiety status and traits	Quasi-experimental/78 family caregivers	Reduced state anxiety in family caregivers of stroke patients^†.
Sánchez (2021)1717.Sánchez-Huamash CM, Cárcamo-Cavagnaro C. Videos to improve the skills and knowledge of stroke patients' caregivers. Rev Peru Med Exp Salud Publica [Internet]. 2021 [cited 2024 Jan 15];38(1):41-8. Available from: https://doi.org/10.17843/rpmesp.2021.381.6130 . https://doi.org/10.17843/rpmesp.2021.381... /Peru/ 2.d	Assess the effect of educational videos to improve the practical skills and knowledge of informal caregivers of stroke patients^†.	Caregiver skills, knowledge and satisfaction	Pre- and post-test/10 caregivers	Improved caregivers’ practical skills and knowledge.
Cheng (2018)3030.Cheng HY, Chair SY, Chau JPC. Effectiveness of a strength-oriented psychoeducation on caregiving competence, problem-solving abilities, psychosocial outcomes and physical health among family caregiver of stroke survivors: A randomised controlled trial. Int J Nurs Stud [Internet]. 2018 [cited 2024 Jan 15];87:84-93. Available from: https://doi.org/10.1016/j.ijnurstu.2018.07.005 . https://doi.org/10.1016/j.ijnurstu.2018.... /Hong Kong/ 1.c	Assess the effectiveness of a caregiver-oriented psychoeducational program.	Caregiving competence, problem-solving ability, depressive symptoms, burden on family functioning, social support and physical health of caregivers	RCT^§/128 dyads	Incorporating a psychoeducational program can promote a healthy care transition between family members and stroke survivors^†.

Study	Control	Intervention	Duration/period
Lin et al. (2022)1313.Lin S, Xiao LD, Chamberlain D, Ullah S, Wang Y, Shen Y, et al. Nurse-led health coaching programme to improve hospital-to-home transitional care for stroke survivors: A randomised controlled trial. Patient Educ Couns [Internet]. 2022 [cited 2024 Jan 15];105(4):917-25. Available from: https://doi.org//10.1016/j.pec.2021.07.020 . https://doi.org//10.1016/j.pec.2021.07.0...	Usual discharge plan (health education before discharge and 2 follow-up phone calls after discharge).	Nurse-led coaching program with 2 stages: 1^st pre-discharge coaching sessions with 6 components: 1) goal setting for care transition; 2) enhancing and improving self-care skills; 3) home environment modification; 4) functionality improvement; 5) medication management; (6) management and prevention of adverse events resulting from stroke; 2^nd stage was a 12-week follow-up, with weekly calls and biweekly in-person meetings.	12 weeks/pre and post-discharge
Elsheikh et al. (2022)2020.Elsheikh MA, Moriyama M, Rahman MM, Kako M, EL-Monshed AH, Zoromba M, et al. Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: A randomised controlled trial. BMJ Open [Internet]. 2022 [cited 2024 Jan 10];12(2):e049741. Available from: https://doi.org//10.1136/bmjopen-2021-049741 . https://doi.org//10.1136/bmjopen-2021-04...	Simple educational instructions in a single home visit.	Nurse-led intervention that considered caregivers’ perceived needs in 3 evidence-based dimensions: psychoeducation; skill development; and peer support. The IG received 3 home visits, 6 phone calls, and 1 peer support session so that caregivers could exchange experiences.	6 months/post-discharge
Silva e Boery (2021)1111.Silva JK, Boery RNSO. Effectiveness of a support intervention for family caregivers and stroke survivors. Rev Latino-Am Enferm [Internet]. 2021 [cited 2024 Jan 15];29:e3482. Available from: https://doi.org /10.1590/1518-8345.4991.3482 . https://doi.org /10.1590/1518-8345.4991....	Routine care at health facilities. They did not receive care from any professional who participated in the intervention.	Intervention carried out by a multidisciplinary team in 2 components: individual, with psychotherapy for caregivers; and group, through thematic discussion circles, with the aim of offering guidance and training on care to be performed at home, with monthly 2-hour sessions for 8 months.	8 months/post-discharge
Day et al. (2021)1919.Day CB, Bierhals CCBK, Mocellin D, Predebon ML, Santos NO, Dal Pizzol FLF, et al. Nursing Home Care Intervention Post Stroke (SHARE) 1 year effect on the burden of family caregivers for older adults in Brazil: A randomized controlled trial. Health Soc Care Community [Internet]. 2021 [cited 2024 Jan 15];29(1):56-65. Available from: https://doi.org 10.1111/hsc.13068 . https://doi.org 10.1111/hsc.13068...	The CG was instructed to maintain their usual health monitoring in public and/or private healthcare services and did not receive any intervention.	Educational intervention for family caregivers of older adults after stroke through nursing monitoring, through 3 home visits within a month after hospital discharge. The intervention consisted of preparing caregivers to perform older adults’ daily activities, providing emotional support and guidance on the use of healthcare services.	1 month/post-discharge
Gok Ugur e Erci (2019)66.Gok Ugur H, Erci B. The effect of home care for stroke patients and education of caregivers on the caregiver burden and quality of life. Acta Clin Croat [Internet]. 2019 [cited 2024 Jan 10];58(2):321-32. Available from: https://doi.org//10.20471/acc.2019.58.02.16 . https://doi.org//10.20471/acc.2019.58.02...	No nursing intervention was performed in the CG. However, they used home care services when needed.	Home care provided by nurses and caregiver education. Each patient in the intervention group received 5 home visits, every 15 days, for approximately 40 minutes, during which nursing care was offered, based on activities of daily living, while caregivers received training. At the end of each session, an additional 30 minutes was dedicated to caregivers for conversation and support.	10 weeks/post-discharge
Zhang, Zhang e Sun (2019)55.Zhang L, Zhang T, Sun Y. A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke. Braz J Med Biol Res [Internet. 2019 [cited 2024 Jan 15];52(9):e8533. Available from: https://doi.org/10.1590/1414-431X20198533 . https://doi.org/10.1590/1414-431X2019853...	Caregivers received educational materials and guidance in 2 instruction sessions during hospitalization, provided by a nurse. After discharge, they were followed up by telephone calls every 3 months, and when a nurse asked about a patient’s condition, they provided guidance.	The intervention consisted of 2 phases: in-hospital phase, when nurses delivered educational sessions in person once a week for 1 hour; and phase beginning 7 days after discharge, when caregivers were invited to the hospital every 2 weeks to receive individualized educational sessions lasting 90 minutes, also delivered by nurses. After each session, both in the hospitalization phase and in the post-hospital phase, an additional 30 minutes were allocated for emotional support as well as to help build confidence and solve problems and difficulties.	12 months/pre- and post-discharge
Araújo (2018)1111.Silva JK, Boery RNSO. Effectiveness of a support intervention for family caregivers and stroke survivors. Rev Latino-Am Enferm [Internet]. 2021 [cited 2024 Jan 15];29:e3482. Available from: https://doi.org /10.1590/1518-8345.4991.3482 . https://doi.org /10.1590/1518-8345.4991....	Routine activities of community health units that included home visits according to caregivers’ and patients’ neeeds.	The intervention consisted of training caregivers in mobilization, bathing, transfer, positioning, and feeding techniques, provided at the patients’ home by a multidisciplinary team from community health units during 3 home visits: one week, one month, and three months after hospital discharge. They also received support from these professionals via telephone contact at 3, 6, 8, and 10 weeks after discharge. The study was nurse-led.	3 months/post-discharge
Bakas et al. (2015)2121.Bakas T, Austin JK, Habermann B, Jessup NM, McLennon SM, Mitchell PH, et al. Telephone assessment and skill-building kit for stroke caregivers a randomized controlled clinical trial home. Stroke [Internet]. 2015 [cited 2024 Jan 10];46(12):3478-87. Available from: https://doi.org//10.1161/STROKEAHA.115.011099 . https://doi.org//10.1161/STROKEAHA.115.0...	The ISR CG received a pamphlet from the American Heart Association and 8 weekly calls from a nurse, and a reinforcement call in the 12^th week to provide support through active listening.	In the TASK II intervention, initiated 8 weeks after discharge, in addition to the American Heart Association pamphlet, a guide was provided that included the main caregivers’ needs (information about stroke, providing physical and instrumental care, identifying depressive symptoms, and managing stress). This group also received 8 weekly calls from a nurse with a reinforcement call at week 12. The calls focused on training them to identify and prioritize their needs, locate the corresponding tip in the guide provided, and use skill-building strategies.	12 weeks/post-discharge
Pfeiffer et al. (2014)1414.Pfeiffer K, Beische D, Hautzinger M, Berry JW, Wengert J, Hoffrichter R, et al. Telephone-based problem-solving intervention for family caregivers of stroke survivors: A randomized controlled trial. J Consult Clin Psychol [Internet]. 2014 [cited 2024 Jan 15];82(4):628-43. Available from: https://doi.org//10.1037/a0036987 . https://doi.org//10.1037/a0036987...	The CG received monthly informational letters in addition to usual care.	The intervention was developed by psychologists and consisted of 2 home visits of a maximum of 150 minutes and 18 telephone calls limited to 60 minutes each, over a 3-month intensive intervention and a 9-month maintenance period. The intervention was based on a problem-solving model. The intervention group also received monthly information letters.	9 months/post-discharge
Foster et al. (2013)1818.Forster A, Dickerson J, Young J, Patel A, Kalra L, Nixon J, et al. A structured training programme for caregivers of inpatients after stroke (TRACKS): A cluster randomised controlled trial and cost-effectiveness analysis. Lancet [Internet]. 2013 [cited 2024 Jan 10];382(9910):2069-76. Available from: https://doi.org/10.1016/s0140-6736(13)61603-7 . https://doi.org/10.1016/s0140-6736(13)61...	The CG received usual care according to national stroke protocols.	The intervention was carried out by multidisciplinary teams, and consisted of teaching care techniques and skills to prevent disease worsening, positioning, mobility, transfer, and care for elimination and feeding. The sessions lasted 30 to 45 minutes, and took place between 3 and 5 times in the hospital, and were complemented by a follow-up session after discharge.	Not informed/pre- and post-discharge
Kim et al. (2012)1515.Kim SS, Kim EJ, Cheon JY, Chung SK, Moon S, Moon KH. The effectiveness of home-based individual tele-care intervention for stroke caregivers in South Korea. Int Nurs Rev [Internet] . 2021 [cited 2024 Jan 10];59(3):369-75. Available from: https://doi.org/10.1111/j.1466-7657.2011.00967.x . https://doi.org/10.1111/j.1466-7657.2011...	Before hospital discharge, caregivers received group educational lectures given by nurses, who used PowerPoint^® for the presentation prepared by the researchers.	Before hospital discharge, caregivers in the intervention group received group educational lectures delivered by nurses using PowerPoint^®. After discharge, individual telecare intervention was offered for 3 months (twice a week during the first month after discharge, once during the second month, and twice a week during the third month). The approach consisted of identifying the family’s needs, providing information or re-education, and emotional and social support.	3 months/pre- and post-discharge
Perrin et al. (2010)1616.Perrin PB, Johnston A, Vogel B, Heesacker M, Vega-Trujillo M, Anderson J, et al. A culturally sensitive transition assistance program for stroke caregivers: Examining caregiver mental health and stroke rehabilitation. J Rehabil Res Dev [Internet] . 2010 [cited 2024 Jan 10];47(7):605-17. Available from: https://doi.org/10.1682/JRRD.2009.10.0170 . https://doi.org/10.1682/JRRD.2009.10.017...	The CG received usual care (no description).	The intervention, consisting of 3 components (skills development, education and problem-solving support), was developed by a multidisciplinary team and started shortly before hospital discharge, including an in-person meeting with caregivers before discharge, in addition to 4 video calls in the 1^st, 2^nd, 4^th and 6^th week after discharge.	6 weeks/pre- and post-discharge
Shyu et al. (2010)2222.Shyu YL, Kuo L, Chen M, Chen S. A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan. J Clin Nurs [Internet]. 2010 [cited 2024 Jan 10];19(11-12):1675-85. Available from: https://doi.org/10.1111/j.1365-2702.2009.03124.x . https://doi.org/10.1111/j.1365-2702.2009...	Inconsistently, the CG had their discharge needs met within 48 hours of hospital admission, and there was no description of other care.	The intervention, consisting of 3 components (skills development, education and problem-solving support), was developed by a multidisciplinary team and started shortly before hospital discharge, including an in-person meeting with caregivers before discharge, in addition to 4 video calls in the 1^st, 2^nd, 4^th and 6^th week after discharge.	Admission up to one month after discharge/pre- and post-discharge
Mou, Lam, Chian (2023)2323.Mou H, Lam SKK, Chien WT. The effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: A randomised controlled trial. Int J Nurs Stud [Internet]. 2023 [cited 2024 Jan 10];143:104504. Available from: https://doi.org/10.1016/j.ijnurstu.2023.104504 . https://doi.org/10.1016/j.ijnurstu.2023....	Usual care focused on treatments and care provided by physicians, nurses, and rehabilitation services. This group received 1 or 2 health education sessions on lifestyle management provided by nurses or other healthcare professionals.	The program was delivered by a nurse with experience in stroke. Part I aimed to prepare for transition from hospital to home. It included 3 sessions: session 1 - “understanding stroke”; session 2 - “adaptation to care and self-care in daily life”; session 3 - “psychological care”. The sessions took place within 1 week prior to hospital discharge, and lasted 60 minutes each. Part II focused on encouraging dyads to identify distress or difficulties post-stroke and motivate them to deal with these difficulties, providing post-discharge counseling, with 4 weekly phone calls, each lasting 30 minutes. An informational booklet, including the educational content of part I, was used as reference material for the dyads.	3 months/pre- and post-discharge
Bierhals et al. (2023)2424.Bierhals CCBK, Dal Pizzol FLF, Low G, Day CB, Santos NO, Paskulin LMG. Quality of life in caregivers of aged stroke survivors in southern Brazil: A randomized clinical trial. Rev Latino-Am Enferm [Internet]. 2023 [cited 2024 Jan 15];31:e3657. Available from: https://doi.org/10.1590/1518-8345.5935.3657 . https://doi.org/10.1590/1518-8345.5935.3...	They received usual care from the multidisciplinary team and were monitored by the healthcare service network, which normally includes general information about the disease and aspects inherent to care, such as medication administration and nutrition.	The intervention group received usual care and the intervention, which included 3 home visits by two trained nurses, approximately 14, 21, and 30 days after discharge. Nurses engaged in a dialogic process with caregivers, encouraging reflective thinking. Caregivers were asked about their feelings, concerns, and available resources to provide care. Nurses adapted their explanations about how care could best be provided at home.	1 month/post-discharge
Eames (2013)2525.Eames S, Hoffmann T, Worrall L, Read S, Wong A. Randomised controlled trial of an education and support package for stroke patients and their carers. BMJ Open [Internet]. 2013 [cited 2024 Jan 10];3:e002538. Available from: https://doi.org/10.1136/bmjopen-2012-002538 . https://doi.org/10.1136/bmjopen-2012-002...	Standard stroke unit care (medical, nursing assessment) which includes verbal education and counselling.	Occupational therapist-delivered intervention consisting of: (1) a personalized, computer-generated information booklet, with participants choosing topics from a list of 34 items and the desired level of detail in the information; (2) verbal reinforcement of information up to three times before discharge in in-person sessions; (3) monthly telephone contact for 3 months. The calls aimed to assess knowledge, explore barriers and ways to overcome them, and correct misinformation. A telephone number was provided so that participants could call if they had questions.	3 months/pre- and post-discharge
Lelaurin (2021)2626.LeLaurin JH, Lamba AH, Eliazar-Macke ND, Schmitzberger MK, Freytes IM, Dang S, et al. Postdischarge Intervention for stroke caregivers: Protocol for a randomized controlled trial. JMIR Res Protoc [Internet]. 2020 [cited 2024 Jan 15];9(11):e21799. Available from: https://doi.org/ 10.2196/21799 . https://doi.org/ 10.2196/21799...	Participants in the “standard” CG received no intervention but had access to existing resources.	Two-arm intervention delivered by nurses. The intervention is based on the RESCUE website, which includes the following sections: (1) information sheets for caregivers; (2) list of additional resources; (3) self-management; (4) glossary of stroke-related terms; (5) statements; (6) training module; and (7) problem-solving diary. The intervention was delivered by telephone in 4 or 8 weekly sessions lasting 30-60 minutes each, tailored to the specific problems of each caregiver. In the “care” group, nurses encouraged caregivers to discuss caregiving experiences. Sessions lasted 20-30 minutes.	8 weeks/post-discharge
Mclennon (2016)2727.McLennon SM, Hancock RD, Redelman K, Scarton LJ, Riley E, Sweeney B, et al. Comparing treatment fidelity between study arms of a randomized controlled clinical trial for stroke family caregivers. Clin Rehabil [Internet]. 2016 [cited 2024 Jan 10];30(5):495-507. Available from: https://doi.org/0.1177/0269215515585134 . https://doi.org/0.1177/0269215515585134...	Received the standard American Heart Association handout with activity and skill development guidelines for family caregivers.	TASK II was the resource guide. After discharge, caregivers received 1 phone call per week for 8 weeks from nurses. A follow-up call was made at week 12. The calls were recorded for self-assessment and comparison. Moreover, caregivers received a pamphlet from the American Heart Association. During the calls, patients’ care needs were assessed and caregiver training was provided.	12 weeks/post-discharge
Pitthayapong (2017)2828.Pitthayapong S, Thiangtam W, Powwattana A, Leelacharas S, Waters CM. A community based program for family caregivers for post stroke survivors in Thailand. Asian Nurs Res [Internet]. 2017 [cited 2024 Jan 15];11(2):150e157. Available from:Available from: https://doi.org/10.1016/j.anr.2017.05.009 . https://doi.org/10.1016/j.anr.2017.05.0...	Routine care provided by health centers. A nurse visited patients at least once in the first month after discharge and assessed their health status and provided suggestions for improvement.	The intervention, carried out by nurses, consisted of sessions aimed at increasing caregivers’ behavioral skills based on information and motivation. It was divided as follows: week 1 - post-stroke information (duration of 5 days, 2 hours per day); weeks 2 and 3 - review of all previous topics and feedback from family members on the skills learned (2 hours); week 4 - home visit to assess the intervention; week 8 - home visit to encourage and guide.	8 weeks/post-discharge
Azizi (2020)2929.Azizi A, Khatiban M, Mollai Z, Mohammadi Y. Effect of informational support on anxiety in family caregivers of patients with hemiplegic stroke. J Stroke Cerebrovasc Dis [Internet]. 2020 [cited 2024 Jan 10];29(9):105020. Available from: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105020 . https://doi.org/10.1016/j.jstrokecerebro...	The CG received routine care and support (no description).	The intervention was carried out by a nurse. Caregivers received 2-hour training sessions using an expository method and a group question-and-answer session on alternate days until the 9^th day of hospitalization. They also had two bedside patient support sessions lasting up to 1 hour.	10 days/pre-discharge
Sánchez (2021)1717.Sánchez-Huamash CM, Cárcamo-Cavagnaro C. Videos to improve the skills and knowledge of stroke patients' caregivers. Rev Peru Med Exp Salud Publica [Internet]. 2021 [cited 2024 Jan 15];38(1):41-8. Available from: https://doi.org/10.17843/rpmesp.2021.381.6130 . https://doi.org/10.17843/rpmesp.2021.381...	There is no CG.	The intervention was carried out through 8 educational videos on topics such as positioning, mobilization and transfers, implemented in 3 stages. On the 1^st and 2^nd days, caregivers were asked to watch 3 videos, and on the 3^rd day, 2 videos. Professionals were physiotherapists, geriatricians, neurologists and communicators.	3 days/post-discharge
Cheng (2018)3030.Cheng HY, Chair SY, Chau JPC. Effectiveness of a strength-oriented psychoeducation on caregiving competence, problem-solving abilities, psychosocial outcomes and physical health among family caregiver of stroke survivors: A randomised controlled trial. Int J Nurs Stud [Internet]. 2018 [cited 2024 Jan 15];87:84-93. Available from: https://doi.org/10.1016/j.ijnurstu.2018.07.005 . https://doi.org/10.1016/j.ijnurstu.2018....	Routine care provided by rehabilitation services and information leaflets about stroke provided by nurses.	The intervention carried out by a multidisciplinary team offered an educational program for 26 weeks (2 pre-discharge in-person sessions of 45 minutes and 6 biweekly sessions of 30 minutes by telephone after discharge). A book was provided to caregivers.	26 weeks/pre- and post-discharge

[1] CORRESPONDING AUTHOR
Débora Francisco do Canto. dcanto@hcpa.edu.br

Brasil

Brasil

INTERVENCIONES EDUCATIVAS PARA FORMAR A CUIDADORES DE SUPERVIVIENTES DE ACV: REVISIÓN DEL ALCANCE

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