OBJECTIVE: To determine whether a nurse-led support and education programme for spouses of patients affected by stroke improved the psychological health of the spouses. DESIGN: A longitudinal, open, randomized controlled trial. SAMPLE: One hundred spouses of stroke patients were randomly assigned to either an intervention or a control group. SETTING: The study was conducted in a hospital setting. INTERVENTION: The intervention consisted of six group meetings during six months, with a follow-up after further six months. Comparison between the intervention and the control groups was made at baseline, after six and 12 months using analysis with repeated measures. MAIN MEASURES: The Comprehensive Psychopathological Rating Scale--Self-Affective for psychological health. RESULTS: No significant difference was found between the intervention and control groups concerning overall psychological health. However, a subanalysis revealed that those who participated more frequently in the group meetings (five or six times) had significantly stronger psychological health (P<0.05). Knowledge about stroke increased over time in both groups, but participants in the intervention group learned more (P=0.041). CONCLUSION: Encouraging participation in the group meetings of a support programme might have a positive effect on psychological health.