Psychological Interventions to Improve Social Participation in Stroke Survivors: A Systematic Review

Abstract

Psychological factors such as low self-esteem, depressive and anxiety symptoms have been found to hinder stroke survivors’ social participation and adversely affect their quality of life. While there have been previous reviews that studied on interventions on social participation after stroke, there is a lack of studies that utilize psychological interventions for participation among stroke survivors. This review aims to provide a comprehensive overview of psychological interventions designed to improve post-stroke participation and assess their effectiveness. Three databases (MEDLINE, Scopus, and Web of Science) were used to identify relevant articles using search terms strategies that are related to stroke, participation and psychological health. Eligible articles are studies
using randomized controlled trial or pre- and post-interventions design that measured participation and psychological outcomes. Eleven studies met the inclusion criteria, with varied sample sizes, intervention types, and measurement tools. The findings revealed that while psychological interventions can improve participation, inconsistencies in measurement and a lack of focus on participation as a primary outcome limit the strength of the conclusions, with some studies did not show long-term improvements. Positive effects on participation were observed in interventions involving home visits with multidisciplinary care, cognitive behavioural therapy (CBT) augmented with occupational therapy, self-management through virtual services, and group music therapy alongside occupational therapy. These findings highlight the need for further research focusing on psychological interventions with participation as primary outcomes in stroke rehabilitation.