Abstract:
Beyond clinical effects, integrating psychological care into the acute/subacute stroke pathway hinges on
operational feasibility—workflow fit, coverage, adherence, acceptability, and safety. We evaluated the
implementation of a brief, structured psychological care pathway in routine practice. Prospective servicedevelopment
cohort (April–August 2025) including consecutive adults with ischemic or hemorrhagic stroke.
The intervention comprised up to six sessions emphasizing psychoeducation, coping skills, problem-solving,
and support. Implementation indicators: eligibility and coverage (proportion enrolled of those admitted),
adherence (sessions completed), acceptability (completion of standardized measures: EQ-5D/VAS, CANSAS,
GAD-7, HAM-A, HAM-D, PHQ-9; MMSE at entry when appropriate), safety (intervention-related adverse
events), and workflow integration (ability to deliver sessions during acute/subacute care). A total of 121
patients were enrolled, with cardiometabolic comorbidities common. The pathway was delivered without
disrupting medical care; most patients completed ≥4 sessions and pre/post assessments, indicating good
acceptability and manageable administrative load. No intervention-related adverse events were reported.
Standardized tools facilitated interdisciplinary communication and needs prioritization (via CANSAS), while
early in-hospital initiation improved coverage. From an implementation standpoint, brief integrated
psychological care proved feasible in an acute setting and shows potential to improve patient-reported
outcomes and continuity of care after discharge.
