A Mindful Approach to Managing Stress in Stroke Survivors and Support Persons: Feasibility, Acceptability, and Impact of a Stroke-Tailored, Mindfulness-Based Intervention

<p>Stroke recovery often presents psychosocial challenges not only for stroke survivors (SS) but also for their support persons (SP). Guided by the Theory of Dyadic Illness Management, which emphasizes the interdependence and mutual influence between survivor and support person during post-stroke recovery, this dissertation addresses the urgent need for integrative stress management approaches that consider both members of the stroke dyad. Chronic stress has been shown to negatively affect well-being, cognition, and overall quality of life, with detrimental consequences for both individuals within the dyad. A conceptual model, developed by Prather et al. (2022), provides a theoretical foundation for this work, illustrating how mindfulness-based interventions (MBIs) buffer stress, reduce inflammation, and enhance resilience to support both psychological and physical recovery in the context of chronic illness. This framework proposes that MBIs have the potential to disrupt negative feedback loops that drive chronic stress experienced by members of the dyad, thereby improving individual coping capacity and well-being. To inform measurement and intervention design, an integrative review by Prather & Stanfill (2023) examined the use of the Perceived Stress Scale (PSS) during stroke recovery. The review demonstrates that perceived stress is both a persistent and individualized challenge, and higher stress levels are associated with lower resilience, increased depression, cognitive complaints, and poorer functional outcomes. The PSS-10 was identified as the most widely used and reliable tool for capturing these experiences, affirming the need for regular stress assessment in stroke dyads. Building upon these foundations, this dissertation tested the feasibility and acceptability of the “A Mindful Approach to Managing Stress (A-MAMS)” intervention, an 8-week, virtual, asynchronous stroke-tailored MBI (modified, m-MBI) for SS, SP, and stroke dyads. High enrollment, retention, and completion rates were observed, and over 96% of participants found the program effective for managing stress and would recommend it to others, regardless of whether they were participating as individuals or dyads. While no significant differential “dyadic effect” was detected, the findings support the intervention’s broad acceptability and benefit, and emphasize the importance of dyadic frameworks in stroke care. In summary, this research advances the fields of neuroscience-nursing and rehabilitative science by demonstrating that remote, stroke-tailored mindfulness interventions are feasible and well-received among members of the stroke dyad. Findings underscore the value of targeting both survivors and support persons in stress management interventions and call for future large-scale trials to further evaluate the impact of dyadic strategies on well-being and quality of life throughout recovery and reintegration. This work supports the integration of dyadic theory into neuro-rehabilitative practice and provides a foundation for holistic and integrative, SS- and SP-centered post-stroke care.</p>

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Nursing Science

Year dc:date.available

2025

Author dc:creator

• Prather, Jenifer G

Contributors dc:contributor

• Ansley Stanfill

• Chronic Stress
• Dyadic Illness Management
• Mindfulness-based Intervention
• Neuro-rehabilitative Nursing
• Quality of Life
• Stroke Recovery
• Medicine and Health Sciences
• Nursing

Repository record dc:identifier

https://dc.uthsc.edu/dissertations/721

OAI identifier oai:identifier

oai:dc.uthsc.edu:dissertations-1721