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(Stroke. 2003;34:7.)
© 2003 American Heart Association, Inc.

Letters to the Editor

Re: Telephone Intervention With Family Caregivers of Stroke Survivors After Rehabilitation

Department of Medicine and Psychiatry, Case Western Reserve University, Cleveland, Ohio

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Grant et al¹ find that healthcare professionals are challenged to develop effective intervention programs that will assist family caregivers to effectively manage caregiver problems. It is possible these changes may have beneficial effects for stroke survivors who are indeed sensitive and reactive to caregiver coping behavior. Family members arranged to talk with the research nurse later in the day if they were busy with other activities. Perhaps this flexibility in rescheduling telephone contacts allowed caregivers to better focus and develop more rational problem-solving skills in addressing problems.

This strategy is suggested by a report that pausing before taking action in stress management relative to usual care of mental stress–induced myocardial ischemia in men has substantial and immediate clinical and economic benefits. This hypothesis is supported by (1) the association of the reduction of blood pressure with longer, less recurrent speech hesitation pauses (about 2 seconds); (2) a report linking 3-second intertrial intervals with integration of target and body-part information in the premotor cortex when planning action; (3) the association of 2- to 4-second periods of rest with significant cognitive activity²; and (4) a 2.5- to 3-second delay period for inhibition shaping the temporal flow of information in the prefrontal cortex.³

These findings give precise, objective methods to facilitate problem-solving training¹ and save travel time by remote acquisition of temporal features of expressive activity in spontaneous dialogues, reflecting neuronal activity and firing.^2,4

1. Grant JS, Elliott TR, Weaver M, Bartolucci AA, Giger JN. Telephone intervention with family caregivers of stroke survivors after rehabilitation. Stroke. 2002; 33: 2060–2065.[Abstract/Free Full Text]

2. Friedman EH. Neurobiology of psychosocial treatment of mental stress-induced myocardial ischemia in men. Am J Cardiol. 2002; 90: 86–87. Letter.

3. Constantinidis C, Williams GV, Goldman-Rakic PS. A role for inhibition in shaping the temporal flow of information in prefrontal cortex. Nat Neurosci. 2002; 5: 175–180.[CrossRef][Medline] [Order article via Infotrieve]

4. Toon PD. Using telephones in primary care: A significant proportion of consultations might take place by phone. BMJ. 2002; 324: 1230–1231.[Free Full Text]

University of Alabama School of Nursing, University of Alabama at Birmingham

Response

Dr Friedman was helpful in sharing empirical evidence from other studies regarding precise and objective methods that illustrate . . . [Full Text of this Article]

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