(duplicate) SUPERB trial
Research type
Research Study
Full title
Adjustment with aphasia after stroke: Exploring the feasibility of a definitive phase III RCT for SUpporting wellbeing through PEeR Befriending (SUPERB)\n
IRAS ID
220281
Contact name
Katerina Hilari
Contact email
Sponsor organisation
City, University of London
Duration of Study in the UK
3 years, 3 months, 30 days
Research summary
Summary of research
This project explores the feasibility of running a large randomised controlled trial to find out if peer support can avert some of the adverse psychological consequences of aphasia, the language and communication disorder that affects about 15% of those who have a stroke. To do this, we will run a feasibility trial, which will include a small pilot. Stroke survivors with long-term aphasia will be trained as peer befrienders. They will be paired with individuals with aphasia who have had more recent strokes, e.g. to offer conversation, help with problem solving and social activities. The peer befrienders will start visiting the participants with aphasia soon after they are discharged from hospital and active community therapy is withdrawn; and will visit them 6-8 times.\n\nSixty participants with aphasia will be recruited in the feasibility trial and eight in the small pilot. All will receive the usual care offered by their Trust; but half (selected randomly) will also receive peer support. The pilot will explore research processes to ensure the trial can run smoothly. The trial will explore the feasibility of a future larger trial based on key issues, such as, how many participants we recruit; how acceptable is peer befriending; how they manage with the questionnaires we use. Participants will complete questionnaires e.g. on mood, participation and social activity several times during the study. ‘Significant others’, such as spouses, will also complete questionnaires on their wellbeing. We will interview a sample of participants and significant others to gain insight into their experiences, and the personal significance of any changes. We will also calculate the costs of usual care and peer support (economic evaluation). Finally, we will explore the possible benefits for those who provide peer support, i.e. the peer befrienders, by interviewing them and testing their wellbeing and feelings of self-efficacy.Summary of Results
Stroke and aphasia can have a profound impact on people’s lives. Depression is common, with a third of people still suffering a year after the stroke. Low mood and depression are even more common in people with aphasia. In the UK, a recent audit of clinical psychology services for people with mood problems after stroke found that the most common provision was monitoring and advice. Less than half of patients with low mood received psychological intervention.The main aims of this study were to explore:
a) Whether one-to-one support from another person with aphasia (peer-befriending) may help; may be a good intervention to explore further.
b) What people with aphasia and their carers thought about peer-befriending
To address these aims, we ran a 1-year development phase and a 2.5-year trial. In our trial, 28 people with aphasia received peer-befriending and were compared to 28 people receiving their usual care. Moreover, we interviewed our participants on their experiences. We also calculated costs for peer-befriending and usual care.
Results of development phase
In the first year of the project, we worked with six people with aphasia who have experience of peer-befriending. They advised us on important aspects of the study, such as:
- information sheets and consent forms
- outcome measures
- training of peer befrienders
- what questions to ask the participants with aphasia, their significant others, and the peer-befrienders.Results of peer-befriending trial
Our study showed that peer-befriending is worth exploring further as an intervention to improve mood for people with aphasia. It showed it was feasible to organise and run a peer-befriending scheme, and it was acceptable to those who received it and those who offered it.
Moreover, there was some evidence that peer-befriending led to better mood outcomes than usual care alone.
In interviews, both peer-befrienders and those having peer-befriending were very positive about it. People with aphasia having peer-befriending and their carers reported benefits for emotional wellbeing and companionship. They valued the shared experience in the befriending relationship.
Peer-befrienders found the role enjoyable and rewarding, and felt they were making a positive difference. They were unanimous in believing that people with aphasia can offer unique and valuable support to others with aphasia.
REC name
London - Bloomsbury Research Ethics Committee
REC reference
16/LO/2187
Date of REC Opinion
27 Jan 2017
REC opinion
Further Information Favourable Opinion