Motivational interviewing to improve dyadic self-care (MOTIVATE-DSC) in stroke survivors and spousal caregivers: randomised controlled trial

Stroke survivors often struggle with self-care behaviours (medication adherence, diet, exercise, and symptom monitoring), yet trials targeting patient self-care alone have yielded inconsistent results. Because many stroke survivors depend heavily on spousal caregivers, dyadic interventions may be more effective. This study aimed to: (1) assess the effect of motivational interviewing (MI) on dyadic self-care in stroke survivors and their spousal caregivers (primary outcomes); and (2) evaluate its impact on secondary outcomes, including stroke health knowledge, mutuality, and self-efficacy. A total of 74 stroke survivor–spousal caregiver dyads were randomly assigned (1:1) to either an MI intervention group or a usual-care control group. Outcomes were assessed at baseline, immediately post-intervention, and at 1-month and 3-month follow-ups. At the 3-month follow-up, the intervention group had significantly higher scores than the control group on all six co-primary outcomes—stroke survivors’ self-care maintenance, monitoring, and management and spousal caregivers’ contributions to each of these behaviours (all P < 0.05). The unadjusted between-group differences were 25.21 points (95% CI 20.34 to 30.09; P < 0.05) for self-care maintenance in stroke survivors and 19.44 points (95% CI 11.11 to 30.56; P < 0.05) for caregiver contribution to self-care maintenance. The MI-based intervention was associated with improvements in dyadic self-care and related psychosocial outcomes in stroke survivor–spousal caregiver dyads. These preliminary findings suggest that targeted behavioural interventions may help reduce stroke-related burden, although further confirmatory trials are warranted. Chinese Clinical Trial Registry (ChiCTR2100053591), registered on 24 November 2021. Available at: https://www.chictr.org.cn/hvshowproject.html? id=114285 .