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Open Access Study protocol

The effectiveness of problem solving therapy for stroke patients: study protocol for a pragmatic randomized controlled trial

Marieke M Visser12*, Majanka H Heijenbrok-Kal12, Adriaan van ’t Spijker3, Gerard M Ribbers12 and Jan JV Busschbach3

Author Affiliations

1 Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands

2 Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, the Netherlands

3 Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Section Medical Psychology and Psychotherapy, PO Box 2040, 3000 CA, Rotterdam, the Netherlands

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BMC Neurology 2013, 13:67  doi:10.1186/1471-2377-13-67

Published: 27 June 2013

Abstract

Background

Coping style is one of the determinants of health-related quality of life after stroke. Stroke patients make less use of active problem-oriented coping styles than other brain damaged patients. Coping styles can be influenced by means of intervention. The primary aim of this study is to investigate if Problem Solving Therapy is an effective group intervention for improving coping style and health-related quality of life in stroke patients. The secondary aim is to determine the effect of Problem Solving Therapy on depression, social participation, health care consumption, and to determine the cost-effectiveness of the intervention.

Methods/design

We strive to include 200 stroke patients in the outpatient phase of rehabilitation treatment, using a multicenter pragmatic randomized controlled trial with one year follow-up. Patients in the intervention group will receive Problem Solving Therapy in addition to the standard rehabilitation program. The intervention will be provided in an open group design, with a continuous flow of patients. Primary outcome measures are coping style and health-related quality of life. Secondary outcome measures are depression, social participation, health care consumption, and the cost-effectiveness of the intervention.

Discussion

We designed our study as close to the implementation in practice as possible, using a pragmatic randomized trial and open group design, to represent a realistic estimate of the effectiveness of the intervention. If effective, Problem Solving Therapy is an inexpensive, deliverable and sustainable group intervention for stroke rehabilitation programs.

Trial registration

Nederlands Trial Register, NTR2509

Keywords:
Problem Solving Therapy; Stroke; Rehabilitation; Coping style; Health-related quality of life