Can Stroke Patients and Their Caregiver Benefit From Additive Mindfulness Training

The main purpose of the study is to find out if MBSR (Mindfulness) in addition to occupational therapy, can improve the therapeutic results in stroke-patients and help relatives of stroke patients to improve their quality of life.

The study seeks primarily to determine the effect of Mindfulness (conducted additionally to occupational therapy) on physical and mental capabilities of life of stroke patients.

Furthermore, we want to find out if Mindfulness has a positive impact towards the quality of life and the daily burden of stroke patients and their caregivers.

The overall purpose of this study is to evaluate the feasibility of the process-basis, resources-basis, management-basis, and scientific basis for a further larger study. We want to conduct an exploratory case study as an A-B Design in which the A-Phase is "only regular occupational therapy" (no additive intervention) and the B-Phase contains the "regular occupational therapy" and "MBSR" (Mindfulness-Course; intervention).

Four stroke patients and their closest relative will be included in the study (n=8).

The study is non-blinded and no randomised allocation will take place. We will compare the outcomes of Phase B with the outcomes of Phase A of every person.

The purpose of the exploratory case study is to analyse the feasibility of the study design that will be used in a subsequent research study.

The study will last 16 weeks; split into two parts of eight weeks (A Phase and B-Phase).

1. Baseline Measurement

   If the patient and the caregivers are included into the study they perform several measurements and questionnaires:
   * Measurements to assess physical capabilities (Patient)
   * Measurement to assess attention (Patient)
   * Measurements to assess Quality of life daily burden of illness and caregiving (Patient and Caregiver
   * Semi structured Interviews (Patient and Caregiver)
2. A-Phase The stroke patient continues his/her regular occupational treatment for eight weeks.

   The caregivers get no study-related treatment.
3. 2nd (Midterm)-Measurement Same procedure as the baseline measurement.
4. B-Phase (Intervention Phase) Within the B-Phase of the study, the participant gets Mindfulness Training (intervention) in addition to the regular occupational therapy.

   Before Patients and Caregivers start the MBSR Course (Mindfulness) the get information from an experienced Mindfulness trainer about e.g. duration, contents of the course, etc. They have the opportunity to ask questions.

   The course lasts eight weeks. The MBSR group meet every week for 2.5h. The participants will get "homework" that they to perform at home (1h per day). If the duration of practice is to burdensome for the participants, then they can talk to the MBSR-trainer about time reduction.
5. 3rd (Final) Measurement Same procedure as the baseline and second (Midterm-) measurement.

Eligibility Criteria:
Inclusion Criteria:

* Participants (out-patients) fulfilling all of the following inclusion criteria are eligible for the study:
* Informed Consent as documented by signature (Appendix Informed Consent Form)
* Adult stroke patients (outpatients) who gets regular occupational therapy
* Time after stroke at least 6 months
* Modified Rankin Scale ≥1≤ 4
* Mini Mental State ≥ 24

Participants (caregivers) fulfilling all of the following inclusion criteria are eligible for the study:

* Close relative who is primary in charge and bear the largest burden of the caregiving of the stroke patient

Exclusion Criteria:

* Co-Morbidity (e.g. severe psychological, neurological disorders)
* Severe cognitive disorders
* Severe speech comprehension disorders
* Known or suspected drug, medication or alcohol abuse
* Inability to follow the procedures of the study, e.g. due to language