The HEADS: UP development study : working with key stakeholders to adapt a mindfulness-based stress reduction course for people with anxiety and depression after stroke

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Lawrence, Maggie and Davis, Bridget and De Amicis, Leyla and Booth, Jo and Dickson, Sylvia and Dougall, Nadine and Grealy, Madeleine and Jani, Bhautesh and Maxwell, Margaret and Parkinson, Ben and Pieri, Matilde and Mercer, Stewart (2023) The HEADS: UP development study : working with key stakeholders to adapt a mindfulness-based stress reduction course for people with anxiety and depression after stroke. Healthcare, 11 (3). 355. ISSN 2227-9032 (https://doi.org/10.3390/healthcare11030355)

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Abstract

Background: Following stroke, rates of mood disorder are and remain high at five years (anxiety 34.4%; depression 23%). Structured mindfulness-based stress reduction (MBSR) courses are effective in a range of health conditions, but stroke survivors find adherence challenging. We aimed to adapt a standard MBSR course specifically for people affected by stroke. Methods: We recruited stroke survivors and family members with symptoms of anxiety and/or depression to take part in a co-development study comprising two rounds of MBSR 'taster' sessions, followed by focus groups in which views were sought on the practices sampled. Data were collected in October 2017 and May 2018 and were analysed using framework analysis, informed adaptations to mindfulness materials and delivery. Results: Twenty-eight stroke survivors and seven family members participated. Nineteen (76%) stroke survivors had anxiety; 15 (60%) had depression. Five (71.4%) family members reported anxiety; n = 4 (57.1%) depression. Thirty participants attended the first round of taster sessions and focus groups; twenty (66%) the second and three (10%) were unable to attend either round. Framework analysis informed adaptations to course delivery, practices, and materials, ultimately resulting in a stroke-specific MBSR course, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). Conclusions: HEADS: UP may provide a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder.

ORCID iDs

Lawrence, Maggie, Davis, Bridget, De Amicis, Leyla, Booth, Jo, Dickson, Sylvia, Dougall, Nadine, Grealy, Madeleine ORCID logoORCID: https://orcid.org/0000-0002-2823-8841, Jani, Bhautesh, Maxwell, Margaret, Parkinson, Ben, Pieri, Matilde and Mercer, Stewart;
CORE (COnnecting REpositories)