The provision of the FSO service to all those admitted to
hospital with stroke is consistent with the policies of the
Stroke Association’s FSO service. Most patients and caregivers
were provided information early after stroke. However,
when the service was originally developed, professionals
referred people to the FSO service, and the FSO worked
almost exclusively with families after hospital discharge. The
broadening of the service to encompass early intervention in
hospital and later intervention at home may have reduced its
effectiveness. However, such neutral effects on patients’ and
caregivers’ psychological health are not specific to the Stroke
Association’s FSO service. It appears from studies done
outside the United Kingdom that the enduring psychological
effects of stroke are also not adequately addressed in other stroke support services,11 suggesting that the effectiveness of
the FSO service is representative of other relatively shortterm,
early stroke interventions.
In response to observations in previous UK trials, this
research was carried out in a relatively underdeveloped stroke
service. In light of our findings, however, we would suggest
that it is not the location but rather the timing of when the
service is provided and to whom that matter. For example, a
stated aim of the service is to make contact as soon as
possible after the stroke (the critical period). However, many
are still receiving conventional care from the hospital team,
so potential problems might have already have been predicted
and managed by the hospital team. This seems likely to have
occurred because a qualitative study undertaken in addition to
this main trial found that patients and caregivers in the control
group reported that most of the necessary support was found
through professionals in the hospital team who provided
poststroke care
The provision of the FSO service to all those admitted tohospital with stroke is consistent with the policies of theStroke Association’s FSO service. Most patients and caregiverswere provided information early after stroke. However,when the service was originally developed, professionalsreferred people to the FSO service, and the FSO workedalmost exclusively with families after hospital discharge. Thebroadening of the service to encompass early intervention inhospital and later intervention at home may have reduced itseffectiveness. However, such neutral effects on patients’ andcaregivers’ psychological health are not specific to the StrokeAssociation’s FSO service. It appears from studies doneoutside the United Kingdom that the enduring psychologicaleffects of stroke are also not adequately addressed in other stroke support services,11 suggesting that the effectiveness ofthe FSO service is representative of other relatively shortterm,early stroke interventions.In response to observations in previous UK trials, thisresearch was carried out in a relatively underdeveloped strokeservice. In light of our findings, however, we would suggestthat it is not the location but rather the timing of when theservice is provided and to whom that matter. For example, astated aim of the service is to make contact as soon aspossible after the stroke (the critical period). However, manyare still receiving conventional care from the hospital team,so potential problems might have already have been predictedand managed by the hospital team. This seems likely to haveoccurred because a qualitative study undertaken in addition tothis main trial found that patients and caregivers in the controlgroup reported that most of the necessary support was foundthrough professionals in the hospital team who providedpoststroke care
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