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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

Lawrence, Maggie; Davis, Bridget; De Amicis, Leyla; Booth, Jo; Dickson, Sylvia; Dougall, Nadine; Grealy, Madeleine; Jani, Bhautesh; Maxwell, Margaret; Parkinson, Ben; Pieri, Matilde; Mercer, Stewart

Authors

Maggie Lawrence

Bridget Davis

Leyla De Amicis

Jo Booth

Sylvia Dickson

Madeleine Grealy

Bhautesh Jani

Margaret Maxwell

Ben Parkinson

Matilde Pieri

Stewart Mercer



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.

Citation

Lawrence, M., Davis, B., De Amicis, L., Booth, J., Dickson, S., Dougall, N., Grealy, M., Jani, B., Maxwell, M., Parkinson, B., Pieri, M., & Mercer, S. (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), Article 355. https://doi.org/10.3390/healthcare11030355

Journal Article Type Article
Acceptance Date Jan 22, 2023
Online Publication Date Jan 26, 2023
Publication Date 2023
Deposit Date Jan 23, 2023
Publicly Available Date Feb 6, 2023
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 11
Issue 3
Article Number 355
DOI https://doi.org/10.3390/healthcare11030355
Keywords stroke, mindfulness-based stress reduction, anxiety, depression, co-development, adaptation, complex intervention

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