COCHRANE NURSING CARE CORNER Summaries of Nursing Care-Related Systematic Reviews from the Cochrane Library Interventions for treating anxiety after stroke Question The question that the review originally attempted to answer is whether an intervention to treat for anxiety after stroke will decrease the proportion of patients who suffer from these co-morbid anxiety disorders after suffering a stroke. Further, it wished to determine what effect such treatment would have on the quality of life, disability, depression, social par- ticipation, risk of death or caregiver burden experienced by these patients. Because of the lack of studies that dealt solely with anxiety, the review was expanded to include the co-morbid conditions of depression and anxiety, instead of just anxiety. Relevance to nursing care According to the review, stroke is the leading cause of adult disability (age-adjusted prevalence of stroke ranges from 1.3% to 3.2% for Americans aged 20 and older). 1 Addition- ally, following a physical stroke, 20% to 25% of stroke sur- vivors will also suffer from one of several types of mental anxiety. While there are several distinct types of anxiety disorders (general anxiety disorder, panic disorder, social phobia, obsessive compulsive disorder and post-traumatic stress disorder), they do share several common characteris- tics of excessive and irrational fear, subjective apprehension and difficulty and distress in managing daily tasks. These conditions can affect the patient even several years following the initial stroke event. Whether in a stroke unit, in a reha- bilitation setting or a medical/surgical unit following any hospital readmission, a percentage of patients will be post- stroke, and it is necessary to be aware of these likely co-morbid conditions, and the most appropriate interven- tion to employ to best aid the patient. When employing an intervention, it is also necessary to be aware of and examine the side effects and total benefits of the intervention. Side effects of the studied medications included minor nausea or stomach distension, dizziness, vomiting and heart palpita- tions. Whether this Cochrane review will lead to any changed interventions is questionable. Study characteristics Using the exclusion criteria, the reviewers were not able to include any studies that solely looked at anxiety as a com- plication of stroke. The only studies that they were able to include in the review were of stroke with co-morbid condi- tions of anxiety and depression. The intervention studied was the use of any therapy, whether pharmacological, psy- chological or complementary or alternative therapies. The therapy’s primary purpose needed to be treatment of the disorder or anxiety symptoms. First, there were only two studies that met all of the researchers’ criteria for evaluation; second, a total of only 175 patients were involved in the chosen studies; and finally, neither of the two included studies used a study arm of placebo intervention. Both studies used standard treatment (routine treatment) as their common control arm. The studies used the Hamilton Anxiety Scale (HAM-A) to assess anxiety and the Hamilton Depression Scale (HAM-D) to assess depression. Both included studies were conducted in China. Neither study article is indexed in the US MEDLINE database. The search strategies used to find the articles are detailed in the Appendices of the review. Significantly, the searches were NOT limited to the English language. Extensive searches were conducted, using trials register of the Cochrane Stroke Group, CENTRAL, MEDLINE, EMBASE, PsycINFO, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health (CINAHL), Proquest Digital Dissertations and Psychological Database for Brain Impairment Treatment Efficacy (PsycBITE). Database searches ranged from a start date of 1806 to 2004, with an end date of October 2010. Additional searches were con- ducted using hand searching, networking, conference pro- ceedings, expert reviews, etc. of published and unpublished literature and sources. This is a summary of a Cochrane Review. The full citation and the names of the researchers who conducted the Review are listed in the Reference section below. doi:10.1111/j.1744-1609.2012.00259.x Int J Evid Based Healthc 2012; 10: 82–83 © 2012 The Author International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute