The effectiveness of interventions to support informal stroke carers: a systematic review

Stroke affects one in four adults in the UK, with over a third relying on informal carers. The burden of care can have detrimental effects on the mental and physical health of carers, which may impact the rehabilitative process. Despite this, interventions have focused on the physical demands of caregiving, prioritising the stroke survivor. This review aimed to identify effective psychosocial interventions that reduce burden, strain, depression, or anxiety in informal stroke carers. A systematic review of the literature was conducted using MEDLINE, EMBASE, PsycINFO, the Cochrane Library, and PubMed, with final searches on the 8th May 2025. Randomised controlled trials (RCTs) published in English from 1980 onwards, including participants aged 18 years or older, were eligible. Risk of bias was assessed using the CASP tool for RCTs. Results were reported using narrative synthesis. Seven studies were rated as having good methodological quality, fourteen moderate, and three weak. Fourteen studies reported significant findings. Interventions varied widely, with characteristics of effective interventions including skills-based problem-solving content, telephone delivery, longer duration, and increased contact time. Providing remote support over extended durations may improve the psychological well-being of informal stroke carers. Tentative conclusions are presented, and further research is required. Prioritise remote interventions with sustained contact and tailored education to enhance stroke carer competence and long-term engagement.Incorporate routine assessments of stroke carer needs and digital accessibility to ensure equitable participation in remotely delivered support.Embed cost-effectiveness evaluations into intervention design to inform sustainable, scalable stroke carer support strategies. Prioritise remote interventions with sustained contact and tailored education to enhance stroke carer competence and long-term engagement. Incorporate routine assessments of stroke carer needs and digital accessibility to ensure equitable participation in remotely delivered support. Embed cost-effectiveness evaluations into intervention design to inform sustainable, scalable stroke carer support strategies.

在英国，每四名成年人中就有一人罹患中风，其中超过三分之一的患者需要依靠非正式照护者提供照料。照护负担会对照护者的身心健康产生不利影响，进而可能影响患者的康复进程。尽管如此，现有照护干预多聚焦于照护工作的体力负荷，将中风幸存者的需求置于优先地位。本系统综述旨在识别可有效减轻非正式中风照护者照护负担、心理压力、抑郁或焦虑情绪的社会心理干预措施。
本研究通过MEDLINE、EMBASE、PsycINFO、Cochrane图书馆及PubMed数据库开展文献系统综述，最终检索于2025年5月8日完成。本研究纳入1980年至今以英语发表、研究对象为18岁及以上人群的随机对照试验（Randomised Controlled Trials, RCTs）。采用针对随机对照试验的CASP偏倚风险评估工具对纳入研究的偏倚风险进行评价。研究结果采用叙述性综合法进行报告。
7项研究被评为方法学质量良好，14项为中等质量，3项为低质量。14项研究报告了具有统计学意义的研究结果。各类干预措施差异较大，有效干预措施的共同特征包括基于技能的问题解决模块、电话递送形式、更长的干预时长以及更多的接触时间。长期提供远程照护支持，或许可改善非正式中风照护者的心理福祉。本综述给出了初步结论，未来仍需开展更多相关研究。
优先选用具备持续接触机制与个性化教育内容的远程干预措施，以提升中风照护者的照护能力与长期参与意愿。
定期开展中风照护者需求评估与数字可及性评估，确保其能公平参与远程照护支持服务。
将成本效益评价嵌入干预方案设计中，为可持续、可规模化的中风照护支持策略制定提供依据。
优先选用具备持续接触机制与个性化教育内容的远程干预措施，以提升中风照护者的照护能力与长期参与意愿。
定期开展中风照护者需求评估与数字可及性评估，确保其能公平参与远程照护支持服务。
将成本效益评价嵌入干预方案设计中，为可持续、可规模化的中风照护支持策略制定提供依据。