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Sun YA, Kalpakavadi S, Prior S, Thrift AG, Waddingham S, Phan H, Gall SL. Socioeconomic status and health-related quality of life after stroke: a systematic review and meta-analysis. Health Qual Life Outcomes 2023; 21:115. [PMID: 37875951 PMCID: PMC10599023 DOI: 10.1186/s12955-023-02194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Socioeconomic status (SES) is associated with stroke occurrence and survival following stroke but its association with health-related quality of life (HRQoL) following stroke remains uncertain. We performed a systematic review and meta-analysis to examine the association between SES and HRQoL after stroke. METHODS PubMed, SCOPUS, EMBASE, and Web of Science were searched to identify relevant cohort and case-control studies between January 2000 and May 2022. Two authors screened titles, abstracts and full text articles. One author extracted data from all included studies. Meta-analyses were performed for studies with comparable measurements of SES and HRQoL. Random effects models were used to estimate pooled summary standardised mean differences in HRQoL by SES. RESULTS Out of 1,876 citations, 39 studies incorporated measurement of overall HRQoL following stroke and were included in the systematic review, with 17 studies included in the meta-analyses. Overall, reports including education, income, occupation and work status effects on HRQoL after stroke were inconsistent among all included 39 studies. In the global meta-analysis of 17 studies, HRQoL among survivors of stroke was lower in the low SES group than in the high SES group (standardised mean difference (SMD) -0.36, 95% CI -0.52, -0.20, p < 0.0001). When using education and income indicators separately, summary effects were similar to those of the global analysis (low versus high education SMD -0.38, 95% CI -0.57, -0.18, p < 0.0001; low versus high income SMD -0.39, 95% CI -0.59, -0.19, p < 0.0001). CONCLUSIONS Across all SES indicators, people with stroke who have lower SES have poorer overall HRQoL than those with higher SES. Accessibility and affordability of poststroke support services should be taken into consideration when planning and delivering services to people with low SES.
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Affiliation(s)
- Yichao A Sun
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Serah Kalpakavadi
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Sarah Prior
- Tasmanian School of Medicine, Rural Clinical School, University of Tasmania, Burnie, Australia
| | - Amanda G Thrift
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | | | - Hoang Phan
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
- Menzies School for Health Research, Charles Darwin University, Casuarina, Australia
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
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Qi WG, Xia Y, Miao M, Gan Y. One Meaning for Two Persons: An Actor-Partner Interdependence Model Analysis of Meaning in Life, Anxiety, and Depression Among Rehabilitation Patients and Caregivers. J Am Med Dir Assoc 2023; 24:1054-1060. [PMID: 36870365 DOI: 10.1016/j.jamda.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE Patients and caregivers in the inpatient physical rehabilitation setting are presented with life-changing medical conditions, and their meaning in life can change dramatically. Meaning in life is associated with fewer depressive and anxiety symptoms, but little is known about how they are related interdependently among patients and caregivers. In the current study, we aim to explore their dyadic relationships. DESIGN Actor-partner interdependence model through structural equation modeling for dyadic analyses. SETTING AND PARTICIPANTS A total of 160 pairs of patients and caregivers recruited from 6 inpatient rehabilitation hospitals in China. METHODS Cross-sectional surveys were conducted among pairs of rehabilitation patients and caregivers. The presence of and search for meaning were measured with the Meaning in Life Questionnaire. RESULTS In 2 separate models, we found that patients' presence of meaning was negatively associated with their own depression (β = -0.61, P < .001) and anxiety (β = -0.55, P < .001), as well as their caregivers' depression (β = -0.32, P < .001) and anxiety (β = -0.31, P < .001). However, the caregivers' presence of meaning was only negatively associated with their own depression (β = -0.25, P < .05) and anxiety (β = -0.21, P < .05). A search for meaning was not significantly associated with depression or anxiety. CONCLUSIONS AND IMPLICATIONS The results indicate that the anxiety and depressive symptoms of rehabilitation inpatients and caregivers are associated with their own level of presence of meaning. Caregivers' depression and anxiety are interdependently associated with patients' presence of meaning. Clinicians should take dyadic interdependence into consideration when providing psychological services to rehabilitate patients and their caregivers. Meaning-centered interventions can be helpful for the dyads' meaning-making and mental health.
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Affiliation(s)
- Wei Gabriel Qi
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Yunhua Xia
- Beijing Huasheng Rehabilitation Hospital, Beijing, China
| | - Miao Miao
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China.
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
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Patients Satisfied with Care Report Better Quality of Life and Self-Rated Health-Cross-Sectional Findings Based on Hospital Quality Data. Healthcare (Basel) 2023; 11:healthcare11050775. [PMID: 36900780 PMCID: PMC10001220 DOI: 10.3390/healthcare11050775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Satisfaction with care is an important indicator of health care quality. However, if this process measure is associated with patients' outcomes in real-world data is largely unknown. We, therefore, aimed to evaluate if satisfaction with physician- and nurse-related care is associated with quality of life and self-rated health among inpatients at the University Hospital Hamburg-Eppendorf in Germany. METHOD We used standard hospital quality survey data of 4925 patients treated at various departments. We used multiple linear regressions to examine an association between satisfaction with staff-related care and quality of life as well as self-rated health, adjusted for age, gender, mother tongue, and treating ward. Patients rated their satisfaction with physician- and nurse-related care from 0 "not at all" to 9 "very much". The outcomes regarding quality of life and self-rated health were evaluated on five-point Likert scales ranking from 1 "bad" to 5 "excellent". RESULTS We found that satisfaction with physician-related care was positively associated with quality of life (ß = 0.16; p < 0.001) as well as with self-rated health (ß = 0.16; p < 0.001). Similar findings were observed for satisfaction with nurse-related care and the two outcomes (ß = 0.13; p < 0.001 and ß = 0.14; p < 0.001, respectively). CONCLUSION We show that patients who are more satisfied with staff-related care report better quality of life and self-rated health than patients less satisfied with care. Thus, patient satisfaction with care, is not only a process measure indicating the quality of care but is also positively associated with patient-reported outcomes.
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O'Shannessy E, Reeder S, Vishwanath S, Hill S, Perta A, Jolliffe L, Morarty J, Hunter P, Lannin NA. Mixed methods study to understand the experiences of adults with acquired brain injury and their family members who receive specialised rehabilitation. BRAIN IMPAIR 2023; 24:39-53. [PMID: 38167579 DOI: 10.1017/brimp.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM Rehabilitation therapy is a key part of the recovery pathway for people with severe acquired brain injury (ABI). The aim of this study was to explore inpatients' and their family members' experiences of a specialist ABI rehabilitation service. METHODS A cross sectional, prospective mixed method study was undertaken at a metropolitan specialist ABI rehabilitation unit in Victoria, Australia. All inpatients and their family members of the service were invited to complete a satisfaction survey. Employing purposive sampling, semi-structured interviews were conducted with inpatients and/or their family members. RESULTS In total, 111 people completed the satisfaction survey and 13 were interviewed. High levels of satisfaction with the specialist service were reported; the majority of inpatients (74%) and family members (81%) rated the overall quality of care received in the service as 'high' or 'very high'. Interviews revealed four main themes: (i) satisfaction with rehabilitation services, (ii) inconsistent communication, (iii) variable nursing care, and (iv) strengths and weakness of the rehabilitation environment. Overall, important components of a positive experience were being involved in decision making and discharge planning, effective communication and information processes, and being able to form therapeutic relationships with staff. Key sources of dissatisfaction for inpatients and family members related to inconsistency in care, accessing information about treatments in a format easily understood, and communication. CONCLUSION Specialised rehabilitation is valued by inpatients and their family members alike. The findings highlight the importance of exploring inpatient experiences to optimise service delivery in a tailored, specialised rehabilitation programme.
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Affiliation(s)
| | - Sandra Reeder
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Swarna Vishwanath
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Sophie Hill
- La Trobe University, Melbourne, VIC, Australia
| | | | - Laura Jolliffe
- Alfred Health, Melbourne, VIC, Australia
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia
| | | | | | - Natasha A Lannin
- Alfred Health, Melbourne, VIC, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
- La Trobe University, Melbourne, VIC, Australia
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Joundi RA, Adekanye J, Leung AA, Ronksley P, Smith EE, Rebchuk AD, Field TS, Hill MD, Wilton SB, Bresee LC. Health State Utility Values in People With Stroke: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2022; 11:e024296. [PMID: 35730598 PMCID: PMC9333363 DOI: 10.1161/jaha.121.024296] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
Abstract
Background Health state utility values are commonly used to provide summary measures of health-related quality of life in studies of stroke. Contemporaneous summaries are needed as a benchmark to contextualize future observational studies and inform the effectiveness of interventions aimed at improving post-stroke quality of life. Methods and Results We conducted a systematic search of the literature using Medline, EMBASE, and Web of Science from January 1995 until October 2020 using search terms for stroke, health-related quality of life, and indirect health utility metrics. We calculated pooled estimates of health utility values for EQ-5D-3L, EQ-5D-5L, AQoL, HUI2, HUI3, 15D, and SF-6D using random effects models. For the EQ-5D-3L we conducted stratified meta-analyses and meta-regression by key subgroups. We screened 14 251 abstracts and 111 studies met our inclusion criteria (sample size range 11 to 12 447). EQ-5D-3L was reported in 78% of studies (study n=87; patient n=56 976). The pooled estimate for EQ-5D-3L at ≥3 months following stroke was 0.65 (95% CI, 0.63-0.67), which was ≈20% below population norms. There was high heterogeneity (I2>90%) between studies, and estimates differed by study size, case definition of stroke, and country of study. Women, older individuals, those with hemorrhagic stroke, and patients prior to discharge had lower pooled EQ-5D-3L estimates. Conclusions Pooled estimates of health utility for stroke survivors were substantially below population averages. We provide reference values for health utility in stroke to support future clinical and economic studies and identify subgroups with lower healthy utility. Registration URL: https://www.crd.york.ac.uk/prospero/. Unique Identifier: CRD42020215942.
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Affiliation(s)
- Raed A. Joundi
- Department of Clinical NeurosciencesUniversity of CalgaryAlbertaCanada
- Division of NeurologyHamilton Health SciencesMcMaster University & Population Health Research InstituteHamiltonOntarioCanada
| | | | | | | | | | | | - Thalia S. Field
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | | | - Lauren C. Bresee
- Department of Community Health SciencesUniversity of CalgaryAlbertaCanada
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Hoang MT, Kåreholt I, von Euler M, von Koch L, Eriksdotter M, Garcia-Ptacek S. Satisfaction with Stroke Care Among Patients with Alzheimer's and Other Dementias: A Swedish Register-Based Study. J Alzheimers Dis 2020; 79:905-916. [PMID: 33361596 PMCID: PMC7902943 DOI: 10.3233/jad-200976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Patient dissatisfaction with stroke care is associated with poor self-rated health and unmet care needs. Dementia patients’ satisfaction with stroke care is understudied. Objective: To compare satisfaction with stroke care in patients with and without dementia. Methods: This longitudinal cohort study included 5,932 dementia patients (2007–2017) who suffered a first stroke after dementia diagnosis and 39,457 non-dementia stroke patients (2007–2017). Data were retrieved by linking the Swedish Stroke Register, the Swedish Dementia Register, the Swedish National Patient Register, and the Swedish Prescribed Drug Register. The association between dementia and satisfaction was analyzed with ordinal logistic regression. Results: When dementia patients answered themselves, they reported significantly lower odds of satisfaction with acute stroke care (OR: 0.71; 95% CI: 0.60–0.85), healthcare staff’s attitude (OR: 0.79; 95% CI: 0.66–0.96), communication with doctors (OR: 0.78; 95% CI: 0.66–0.92), stroke information (OR: 0.62; 95% CI: 0.52–0.74); but not regarding inpatient rehabilitation (OR: 0.93; 95% CI: 0.75–1.16), or outpatient rehabilitation (OR: 0.93; 95% CI: 0.73–1.18). When patients answered with caregivers’ help, the association between dementia status and satisfaction remained significant in all items. Subgroup analyses showed that patients with Alzheimer’s disease and mixed dementia reported lower odds of satisfaction with acute care and healthcare staff’s attitude when they answered themselves. Conclusion: Patients with dementia reported lower satisfaction with stroke care, revealing unfulfilled care needs among dementia patients, which are possibly due to different (or less) care, or because dementia patients require adaptations to standard care.
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Affiliation(s)
- Minh Tuan Hoang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Aging Research Network Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
| | - Mia von Euler
- Department of Medical Sciences, School of Medicine, Örebro University, Örebro, Sweden
| | - Lena von Koch
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Theme, Karolinska University Hospital, Stockholm, Sweden.,Section for Neurology, Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden
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7
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Pucciarelli G, Brugnera A, Greco A, Petrizzo A, Simeone S, Vellone E, Alvaro R. Stroke disease-specific quality of life trajectories after rehabilitation discharge and their sociodemographic and clinical associations: A longitudinal, multicentre study. J Adv Nurs 2020; 77:1856-1866. [PMID: 33615532 DOI: 10.1111/jan.14722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/13/2020] [Accepted: 11/24/2020] [Indexed: 11/30/2022]
Abstract
AIM To investigate the longitudinal growth trajectories of disease-specific quality of life (QoL) dimensions and their associations over 1 year. DESIGN A longitudinal design. Data were collected between February 2015-May 2017. METHODS Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope. RESULTS We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12-month follow-up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion. CONCLUSIONS This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables. IMPACT Stroke has a great impact on stroke survivors' QoL. Disease-specific QoL significantly increases from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.
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Affiliation(s)
- Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Antonello Petrizzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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8
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Labberton AS, Augestad LA, Thommessen B, Barra M. The association of stroke severity with health-related quality of life in survivors of acute cerebrovascular disease and their informal caregivers during the first year post stroke: a survey study. Qual Life Res 2020; 29:2679-2693. [PMID: 32388786 PMCID: PMC7561590 DOI: 10.1007/s11136-020-02516-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE To describe the health-related quality of life (HRQoL) of caregivers and survivors of transient ischaemic attack (TIA) and stroke during one year post discharge in comparison to age- and sex-matched population norms; and to analyse the association of initial stroke severity, measured by a routinely used stroke-specific scale, on subsequent HRQoL of caregivers and survivors. METHODS Cohort of hospitalized patients with TIA and stroke discharged alive from a large university hospital in Norway, and their informal caregivers. Questionnaires at 3 and 12 months post discharge were filled out by caregivers (n = 320 and n = 326, respectively) and survivors (n = 368 and n = 383, respectively). Multivariable linear regression analyses tested associations between initial stroke severity (National Institutes of Health Stroke Scale, NIHSS) and HRQoL (EQ-5D-3L) in caregivers and survivors. RESULTS Caregivers of survivors with TIA or stroke did not report lower HRQoL than matched norms. There was some evidence of an association of the NIHSS with caregiver HRQoL at 3 months only (age-sex-adjusted coefficient - 0.01, p = 0.008), however, this was attenuated after additional adjustments. Survivors with stroke, but not TIA, reported lower HRQoL than population norms at both time points. There was a negative association between higher NIHSS scores and survivors' HRQoL; fully adjusted coefficient - 0.01 at both time points (p = 0.001). CONCLUSION The informal caregivers and survivors with TIA did not report lower than expected HRQoL. Increasing stroke severity was associated with decreasing HRQoL among survivors, but had limited predictive value among caregivers. Other factors may therefore be better indicators of 'at risk' caregivers.
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Affiliation(s)
- Angela S Labberton
- Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478, Lørenskog, Norway.
| | - Liv Ariane Augestad
- Department of Health Management and Health Economics, Medical Faculty, University of Oslo, Oslo, Norway
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Mathias Barra
- Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478, Lørenskog, Norway
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Dai W, Liu C, Liu J, Lin Y, Cheng Y, Ming WK. Preference of individuals in the treatment strategies of acute myocardial infarction in China: a discrete choice experiment. Health Qual Life Outcomes 2020; 18:217. [PMID: 32635917 PMCID: PMC7339539 DOI: 10.1186/s12955-020-01466-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 06/26/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is a significant cause of mortality and morbidity worldwide. Today, with increasing life quality and social economy, people pay much attention to the cost-effectiveness of a treatment strategy. This study investigated the preferences of individuals who would be potential caregivers or patients for AMI treatment in order to provide liable and instructive information for cardiologists and other related physicians. METHODS A discrete choice experiment was conducted among people to assess preferences for hypothetical AMI treatment scenarios characterized by the attributes of treatment method, mortality within 5 years, complication rate within 1 year, treatment duration and expense. A conditional logit regression model and latent class analysis were used to interpret the collected data systematically. The relative importance of each attribute and willingness to pay of people on the trade-offs between different treatment strategies were estimated. RESULTS Participants valued mortality within 5 years most highly (average importance: 40.9, 95%CI 0.447-0.530). Three classes of participants were identified: Class 1 placed the most importance on treatment duration, class 2 corresponded with the overall result while expense was regarded as the most important attribute in class 3. Individuals favored an intermediate treatment duration of about 10 days instead of the shortest (95% CI 1.044-1.248, P < 0.001). People's characteristics (sex, age, marriage, education and income) affected their preferences (P < 0.01). CONCLUSION People considered a mortality rate within 5 years as the most crucial attribute in the MI treatment and preferred an intermediate treatment duration of about 10 days. Furthermore, the findings estimated the trade-offs acceptable to patients and heterogeneity in preferences for AMI treatment.
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Affiliation(s)
- Weiqian Dai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China
| | - Chang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China
| | - Jiahe Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China
| | - Yaduan Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China
| | - Yu Cheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China
| | - Wai-Kit Ming
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, TianHe, Guangzhou, Guangdong, China.
- Harvard Medical School, Harvard University, Boston, MA, USA.
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10
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Pucciarelli G, Lommi M, Magwood GS, Simeone S, Colaceci S, Vellone E, Alvaro R. Effectiveness of dyadic interventions to improve stroke patient-caregiver dyads' outcomes after discharge: A systematic review and meta-analysis study. Eur J Cardiovasc Nurs 2020; 20:14-33. [PMID: 33570593 DOI: 10.1177/1474515120926069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 04/23/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Because of the importance of a dyadic approach, it is necessary to conduct a systematic review to identify which dyadic intervention could be implemented for stroke survivor-caregiver dyads after discharge from the rehabilitation hospital to improve outcomes. AIMS The aims were to systematically review the evidence to identify which dyadic interventions have been implemented in stroke survivor-caregiver dyads to improve stroke survivor-caregiver dyads' outcomes and to analyse, through a meta-analysis, which intervention was found to be the most effective. METHODS A systematic review and meta-analysis were conducted using the following electronic databases: PubMed, CINAHL and PsycInfo. Randomized controlled trials (RCTs) and quasi-RCT studies published within the last 10 years were included. Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Pooled effects were analysed between the experimental and control groups for each outcome. RESULTS Sixteen studies involving 2997 stroke survivors (male gender=58%) and 2187 caregivers (male gender=25%) were included in this review. In 16 studies, which were subdivided into three quasi-RCTs and 13 RCTs, the application of dyadic interventions for stroke survivors and caregivers was systematically reviewed, but only a few of these identified a significant improvement in the stroke survivors' and caregivers' outcomes of its intervention group. Dyadic interventions showed a significant effect on stroke survivors' physical functioning (p=0.05), memory (p<0.01) and quality of life (p=0.01) and on caregivers' depression (p=0.05). CONCLUSIONS This study provides moderate support for the use of a dyadic intervention to improve stroke survivors' physical functioning, memory and quality of life and caregiver depression.
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Affiliation(s)
| | - Marzia Lommi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | | | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Sofia Colaceci
- Saint Camillus International University of Health and Medical Sciences, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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11
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Abdul Aziz AF, Tan CE, Ali MF, Aljunid SM. The adaptation and validation of the satisfaction with stroke care questionnaire (Homesat) (SASC10-My™) for use in public primary healthcare facilities caring for long- term stroke survivors residing at home in the community. Health Qual Life Outcomes 2020; 18:193. [PMID: 32563246 PMCID: PMC7305597 DOI: 10.1186/s12955-020-01450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022] Open
Abstract
Background Satisfaction with post stroke services would assist stakeholders in addressing gaps in service delivery. Tools used to evaluate satisfaction with stroke care services need to be validated to match healthcare services provided in each country. Studies on satisfaction with post discharge stroke care delivery in low- and middle-income countries (LMIC) are scarce, despite knowledge that post stroke care delivery is fragmented and poorly coordinated. This study aims to modify and validate the HomeSat subscale of the Dutch Satisfaction with Stroke Care-19 (SASC-19) questionnaire for use in Malaysia and in countries with similar public healthcare services in the region. Methods The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study. Results One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge. Conclusions The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes. Trial registration No.: ACTRN12616001322426 (Registration Date: 21st September 2016.
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Affiliation(s)
- Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Fairuz Ali
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Syed Mohamed Aljunid
- Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
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12
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McCarthy MJ, Lyons KS, Schellinger J, Stapleton K, Bakas T. Interpersonal relationship challenges among stroke survivors and family caregivers. SOCIAL WORK IN HEALTH CARE 2020; 59:91-107. [PMID: 31964295 DOI: 10.1080/00981389.2020.1714827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/10/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. However, as many as 54% of families experience relationship problems after stroke and as many as 38% of couples experience overt conflict. The purpose of this study is to enhance understanding about relationship challenges among stroke dyads and to identify implications for direct practice in social work. Semi-structured interviews were conducted with N = 19 care dyads. Qualitative data were analyzed through an interpretive description lens. Seven themes about relationship challenges were identified. Findings highlight areas to consider in promoting strong relationships between survivors and family caregivers. Social workers may have the opportunity to assist dyads with disrupting negative communication cycles, strengthening empathy and collaboration, and achieving a balance so that each person's needs are met.
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Affiliation(s)
- Michael J McCarthy
- Department of Social Work, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jeffrey Schellinger
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Katie Stapleton
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
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13
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Elegbede VI, Obadeji A, Adebowale TO, Oluwole LO. Comparative assessment of quality of life of patients with schizophrenia attending a community psychiatric centre and a psychiatric hospital. Ghana Med J 2019; 53:92-99. [PMID: 31481804 PMCID: PMC6697764 DOI: 10.4314/gmj.v53i2.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Over the past few decades, there has been an emphasis on the de-institutionalisation of psychiatric care with a focus on community care. With Quality of Life (QoL) as an outcome measure, this study compared the QoL of patients with schizophrenia attending a psychiatric hospital and a community psychiatric centre. DESIGN This was a cross-sectional study in two psychiatric facilities. METHODS Data were obtained through a socio-demographic and clinical questionnaire; the QoL was assessed with the WHOQOL-BREF and patient satisfaction with care with CPOSS. Total and domain scores of WHOQOL-BREF for each group were calculated and compared with each other and other group characteristics. Diagnosis of schizophrenia was based on ICD-10. RESULTS Participants from the two centres did not differ significantly on any of the socio-demographic characteristics measured. Similarly, there was no significant difference in their overall mean WHOQOL-BREF scores as well as the mean WHOQOL-BREF of domain scores. However, the married and females from both centres significantly had higher mean WHOQOL-BREF scores than their male counterparts. Patients in remission for more than two years or those on a single type of medication (either oral or depot preparation) from both centres significantly had higher mean WHOQOL-BREF score compared with those who had less than two years of remission or on both oral and depot preparations. CONCLUSION Overall QoL of patients managed at the two centres was comparable, with similar socio-demographic as well as clinical variables influencing QoL. This suggests that patients with schizophrenia can be well managed at community psychiatric centres. FUNDING None declared.
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Affiliation(s)
| | - Adetunji Obadeji
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Timothy O Adebowale
- Department of Clinical services, Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria
| | - Lateef O Oluwole
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
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14
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Hakobyan L, Nieboer AP, Finkenflügel H, Cramm JM. The Significance of Person‐Centered Care for Satisfaction With Care and Well‐Being Among Informal Caregivers of Persons With Severe Intellectual Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Liana Hakobyan
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Anna P. Nieboer
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Harry Finkenflügel
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
| | - Jane M. Cramm
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University Rotterdam Rotterdam The Netherlands
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15
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Chimatiro GL, Rhoda AJ, De Wit L. Stroke patients' outcomes and satisfaction with care at discharge from four referral hospitals in Malawi: A cross-sectional descriptive study in limited resource. Malawi Med J 2019; 30:152-158. [PMID: 30627348 PMCID: PMC6307053 DOI: 10.4314/mmj.v30i3.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Stroke is the fourth leading cause of mortality and disability in Malawi. There is paucity of studies reporting on acute stroke functional outcomes, quality of life and satisfaction with care among patients with stroke. This study aimed to determine stroke outcomes and satisfaction with care in the country's central hospitals. Methods A descriptive cross-sectional study, recruiting 114 adult patients with stroke and their caregivers, was done. FIM, EQ-5D-5L, SASC and C-SASC were used to collect data. Univariate associations were assessed using the Kruskal-Wallis Test for categorical variables and the Wilcoxon Rank Sum Test for continuous variables. Results With 79% of the original study sample taking part, there was improvement in patients' functional status at discharge compared to on admission with notable improvement in self-care (p<0.001), sphincter control (p<0.001), locomotion (p<0.001), and social cognition (p<0.001), but no significant improvement in transfers (p=1.000), and communication (p=0.865). Satisfaction with care was high, with no significant differences between males and females (p=0.415), age in years (p=0.397), and distance to the clinic (p=0.615). Satisfaction ratings were also high from caregivers' responses and their scores were not associated with age (p=0.663) or distance to the hospital (p=0.872). Quality of life was poor, most patients were either unable or had severe limitation in functional dimensions of mobility (22(28%), self-care (19(25%) and performance of usual activities (25(33%). Every additional year in age was associated with average of 0.36 decrease in quality of life score coefficient, −0.36 (95% CI: −0.63; −0.10); p=0.008. Conclusion Patients with stroke experience improvement in functional outcomes on discharge compared to on admission. Patients and caregivers were satisfied with care provision despite having poor quality of life post stroke treatment. There is need to focus proven interventions on areas of stroke care that can impact patients' quality of life in resource limited settings.
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Affiliation(s)
- George Lameck Chimatiro
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, South Africa
| | - Anthea J Rhoda
- Deputy Dean Teaching and Learning, Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, South Africa
| | - Liesbet De Wit
- Vrije Universiteit Brussel, Department of Public Health, Belgium
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16
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Wittenberg E, James LP, Prosser LA. Spillover Effects on Caregivers' and Family Members' Utility: A Systematic Review of the Literature. PHARMACOECONOMICS 2019; 37:475-499. [PMID: 30887469 DOI: 10.1007/s40273-019-00768-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND A growing body of research has identified health-related quality-of-life effects for caregivers and family members of ill patients (i.e. 'spillover effects'), yet these are rarely considered in cost-effectiveness analyses (CEAs). OBJECTIVE The objective of this study was to catalog spillover-related health utilities to facilitate their consideration in CEAs. METHODS We systematically reviewed the medical and economic literatures (MEDLINE, EMBASE, and EconLit, from inception through 3 April 2018) to identify articles that reported preference-based measures of spillover effects. We used keywords for utility measures combined with caregivers, family members, and burden. RESULTS Of 3695 articles identified, 80 remained after screening: 8 (10%) reported spillover utility per se, as utility or disutility (i.e. utility loss); 25 (30%) reported a comparison group, either population values (n = 9) or matched, non-caregiver/family member or unaffected individuals' utilities (n = 16; 3 reported both spillover and a comparison group); and 50 (63%) reported caregiver/family member utilities only. Alzheimer's disease/dementia was the most commonly studied disease/condition, and the EQ-5D was the most commonly used measurement instrument. CONCLUSIONS This comprehensive catalog of utilities showcases the spectrum of diseases and conditions for which caregiver and family members' spillover effects have been measured, and the variation in measurement methods used. In general, utilities indicated a loss in quality of life associated with being a caregiver or family member of an ill relative. Most studies reported caregiver/family member utility without any comparator, limiting the ability to infer spillover effects. Nevertheless, these values provide a starting point for considering spillover effects in the context of CEA, opening the door for more comprehensive analyses.
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Affiliation(s)
- Eve Wittenberg
- Center for Health Decision Science, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Lyndon P James
- Center for Health Decision Science, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Lisa A Prosser
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan Medical School, Ann Arbor, MI, USA
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17
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Okoye EC, Okoro SC, Akosile CO, Onwuakagba IU, Ihegihu EY, Ihegihu CC. Informal caregivers’ well‐being and care recipients’ quality of life and community reintegration – findings from a stroke survivor sample. Scand J Caring Sci 2019; 33:641-650. [DOI: 10.1111/scs.12657] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Emmanuel Chiebuka Okoye
- Department of Medical Rehabilitation Nnamdi Azikiwe University, Nnewi Campus Nnewi Anambra Nigeria
| | - Sandra Chioma Okoro
- Department of Medical Rehabilitation Nnamdi Azikiwe University, Nnewi Campus Nnewi Anambra Nigeria
| | | | | | - Ebere Yvonne Ihegihu
- Department of Physiotherapy Nnamdi Azikiwe University Teaching Hospital Nnewi Anambra Nigeria
| | - Chima Collins Ihegihu
- Department of Orthopaedic Surgery Nnamdi Azikiwe University Teaching Hospital Nnewi Anambra Nigeria
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18
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Menjivar A, Torres X, Paredes D, Avinyo N, Peri JM, De Sousa-Amorim E, Oppenheimer F, Manyalich M, Diekmann F, Revuelta I. Assessment of donor satisfaction as an essential part of living donor kidney transplantation: an eleven-year retrospective study. Transpl Int 2018; 31:1332-1344. [DOI: 10.1111/tri.13334] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/30/2018] [Accepted: 08/21/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Ana Menjivar
- Medical School; University of Barcelona; Barcelona Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Xavier Torres
- Psychiatry and Clinical Psychology Service; Institut Clinic de Neurociencies; Hospital Clinic of Barcelona; Barcelona Spain
| | - David Paredes
- Medical School; University of Barcelona; Barcelona Spain
- Donation and Transplant Coordination Section; Hospital Clinic of Barcelona; Barcelona Spain
| | - Nuria Avinyo
- Fundació Clínic per a la Recerca Biomèdica; Barcelona Spain
| | - Josep Maria Peri
- Psychiatry and Clinical Psychology Service; Institut Clinic de Neurociencies; Hospital Clinic of Barcelona; Barcelona Spain
| | - Erika De Sousa-Amorim
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Federico Oppenheimer
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Marti Manyalich
- Medical School; University of Barcelona; Barcelona Spain
- Transplant Assessorial Unit; Medical Direction; Hospital Clinic of Barcelona; Barcelona Spain
| | - Fritz Diekmann
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
| | - Ignacio Revuelta
- Medical School; University of Barcelona; Barcelona Spain
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of Nephrology and Renal Transplantation; Hospital Clinic of Barcelona; Barcelona Spain
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19
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Rand S, Forder J, Malley J. A study of dyadic interdependence of control, social participation and occupation of adults who use long-term care services and their carers. Qual Life Res 2017; 26:3307-3321. [PMID: 28786019 PMCID: PMC5681980 DOI: 10.1007/s11136-017-1669-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE Unpaid care is an important source of support of people with long-term conditions. Interdependence of carers' and care recipients' quality of life would be expected due to the relational nature of caregiving. This study aims to explore interdependence of quality of life in carer/care-recipient dyads, especially in relation to mutual interdependence due to social feedback in the caregiving relationship and also the partner effects of one partner's experience of long-term care support on the other's outcomes. METHODS Using data collected in an interview survey of 264 adults with care support needs and their unpaid carers in England, we employed regression analysis to explore whether there is mutual interdependence of care-related quality of life within carer/care-recipient dyads for three quality of life attributes: Control over daily life, Social participation and Occupation. The influence of factors, including satisfaction with long-term care, were also considered on individuals' and dyad partners' care-related quality of life. RESULTS We found mutual interdependence of quality of life at the dyad-level for Control over daily life, but not Occupation or Social participation. A partner effect of care recipients' satisfaction with long-term care on carers' Control over daily life was also observed. Higher care recipient satisfaction with care services was associated with higher Control over daily life. By contrast, for Social participation and Occupation, there were only significant effects of care recipients' satisfaction with long-term care and their own quality of life. CONCLUSIONS These findings highlight the importance of considering the wider impact beyond the individual of long-term care on quality of life in the evaluation of long-term care policy and practice.
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Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK.
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK
| | - Juliette Malley
- Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, Cowdray House, Houghton Street, London, WC2A 2AE, UK
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20
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Reeves MJ, Hughes AK, Woodward AT, Freddolino PP, Coursaris CK, Swierenga SJ, Schwamm LH, Fritz MC. Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol. BMC Neurol 2017. [PMID: 28623892 PMCID: PMC5474297 DOI: 10.1186/s12883-017-0895-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home. Methods The Michigan Stroke Transitions Trial is a randomized, pragmatic, open (un-blinded), 3-group parallel designed superiority trial conducted in 3 Michigan hospitals. Eligible participants are adult acute stroke patients discharged home directly or within 4 weeks of being discharged to a rehabilitation facility. The patient’s primary caregiver is also invited to participate. Patients are randomized on the day they return home using a randomized block design. Consented patients discharged to a rehabilitation facility who do not go home within 4 weeks are dropped from the study. The 2 study interventions begin within a week of returning home and conclude 3 months later. The 3-group design compares usual care to either a home-based social worker stroke case management (SWSCM) program, or a combination of the SWSCM program plus access to an online information and support resource (MISTT website). Outcomes data are collected at 7-days and 90-days by trained telephone interviewers. Primary patient outcomes include the PROMIS global 10 score (a generic Quality of Life scale), and the Patient Activation Measure (PAM). Caregiver outcomes include the Bakas Caregiving Outcomes Scale. Final analysis will be based on 214 randomized acute stroke patients. To accommodate subjects excluded due to prolonged rehabilitation stays, as well as those lost-to-follow-up, up to 315 patients will be consented. Discussion The MISTT study will determine if a home-based case management program designed around the needs and preferences of stroke patients and caregivers, alone or in combination with a patient-centered online information and support resource can improve stroke survivor and caregiver outcomes 3 months after returning home. Trial registration ClinicalTrials.gov: NCT02653170 (Protocol ID: 135457). Registered April 9, 2015.
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Affiliation(s)
- Mathew J Reeves
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, B601 West Fee Hall, East Lansing, MI, 48824, USA.
| | - Anne K Hughes
- School of Social Work, College of Social Science, Michigan State University, East Lansing, MI, USA
| | - Amanda T Woodward
- School of Social Work, College of Social Science, Michigan State University, East Lansing, MI, USA
| | - Paul P Freddolino
- School of Social Work, College of Social Science, Michigan State University, East Lansing, MI, USA
| | - Constantinos K Coursaris
- Department of Media and Information, College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, USA
| | - Sarah J Swierenga
- Usability/Accessibility Research and Consulting, Michigan State University, East Lansing, MI, USA
| | - Lee H Schwamm
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Michele C Fritz
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, B601 West Fee Hall, East Lansing, MI, 48824, USA
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21
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Nunes HJM, Queirós PJP. Patient with stroke: hospital discharge planning, functionality and quality of life. Rev Bras Enferm 2017; 70:415-423. [DOI: 10.1590/0034-7167-2016-0166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/20/2016] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Stroke still causes high levels of human inability and suffering, and it is one of the main causes of death in developed countries, including Portugal. Objective: analyze the strategies of hospital discharge planning for these patients, increasing the knowledge related to hospitalhome transition, discharge planning processes and the main impact on the quality of life and functionality. Method: integrative literature review using the PICOD criteria, with database research. Results: 19 articles were obtained, using several approaches and contexts. For quality of life, the factors related to the patient satisfaction with care and the psychoemotional aspects linked with functionality are the most significant. Conclusion: during the hospitalization period, a careful hospital discharge planning and comprehensive care to patients and caregivers - in particular the functional and psychoemotional aspects - tend to have an impact on the quality of life of patients.
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22
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Guerra HS, Almeida NAM, Souza MRD. Reflection on the public home care caregivers profiles. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.002.ao03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The increase of life expectancy and the decrease in mortality rate have resulted in changes in the epidemiological profile with predominance of non-communicable chronic diseases and global changes in the care system. This scenario has generated increased demands for caregivers, which in Brazilian reality, tends to arise in the family environment. Objective: This study aimed to know and reflect on the caregivers’ profiles of public home care in the city of Goiânia, Goiás. Methods: The data were collected through the application of a caregiver characterization tool and presented descriptively. Results: The caregiver’s profile of this study corroborates the ones described in the specific literature. Most of them are females, married, patient’s spouse or daughter, having health problems, dedicating twelve or more hours to caring and informal exercise of this activity. Conclusion: The results show the significance of family caregivers within the family care and lead to the reflection about this role in the care sphere and the need for public policies that offer a support social network and that are tuned with this reality.
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23
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Pucciarelli G, Vellone E, Savini S, Simeone S, Ausili D, Alvaro R, Lee CS, Lyons KS. Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke: A Longitudinal Dyadic Analysis. Stroke 2017; 48:733-739. [PMID: 28196939 DOI: 10.1161/strokeaha.116.014989] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/09/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to examine changes in stroke survivor and caregiver quality of life (QOL) and to determine whether changes in survivor physical functioning and caregiver burden (ie, the impact of the physical, psychological, and social demands of caregiving) influence changes in QOL. METHODS Longitudinal design with 226 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor physical functioning, caregiver burden, and QOL (physical, psychological, social, and environmental) in both survivor and caregiver. Multilevel modeling was used to control for the interdependence of the data. RESULTS Survivors (50% male sex) and caregivers (66% female sex) were 70.8 (SD=11.9) and 52.4 (SD=13.1) years old, respectively. Over the 12 months, stroke survivor's physical (γ=1.59; P<0.001) and psychological (γ=0.86; P<0.05) QOL significantly improved; social and environmental QOL did not P>0.05. Caregiver QOL, on average, did not significantly change over time P>0.05. Improvements in survivor physical functioning were associated with increases in survivor and caregiver physical and psychological QOL and survivor environmental QOL. Decreases in caregiver burden were significantly associated with improvements in caregiver physical, psychological, and environmental QOL but not with survivor QOL. CONCLUSIONS QOL of stroke survivors and caregivers covaries and is greatly impacted by the physical function changes of the survivor. Dyadic approaches to stroke rehabilitation that acknowledge the interdependence of dyads are needed.
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Affiliation(s)
- Gianluca Pucciarelli
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
| | - Ercole Vellone
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Serenella Savini
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Silvio Simeone
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Davide Ausili
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Rosaria Alvaro
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Christopher S Lee
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Karen S Lyons
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
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Chattat R, Ottoboni G, Zeneli A, Berardi MA, Cossu V, Maltoni M. The Italian version of the FAMCARE scale: a validation study. Support Care Cancer 2016; 24:3821-30. [PMID: 27067593 DOI: 10.1007/s00520-016-3187-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Evaluation of the quality of care is a key element that healthcare providers now take into consideration to meet patients' needs, expectations, and values. The FAMCARE scale is one of the most important instruments available to assess the level of satisfaction about care received by patients and families. We describe the validation process used to develop an Italian version (IF) of the original FAMCARE scale for caregivers. METHODS The IF was prepared according to standard guidelines for translation and transcultural adaptation of self-reported measures. The scale was self-administered to 132 informal caregivers of patients with cancer treated with curative and/or palliative care in a hospice, outpatient, or inpatient setting for at least 1 month. The participant group was composed of spouses (47.73 %), children (31.82 %), siblings (3.03 %), or other relatives (17.42 %). All participants simultaneously completed the EuroQol-5D (EQ-5D) questionnaire to test the construct validity. Twenty-two percent of randomly chosen participants re-completed the test after 1 month to evaluate IF test-retest stability. RESULTS The IF showed a strong reliability with internal consistency [α = 0.93, confidence intervals (CI) = 0.91-0.95] and test-retest stability (Pearson r = 0.38; Kendall's tau-b = 0,25; Spearman's rho =0.34). Factor analysis identified four factors capable of explaining the 63 % total variance which did not change after the Varimax normalized rotation. Notwithstanding the lack of correlation with the VAS component of the EQ-5D questionnaire, our results highlighted robust psychometric properties of the IF. CONCLUSIONS IF is a valid translation of the FAMCARE scale and can be used to assess caregiver satisfaction within the Italian context of cancer palliative care.
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Affiliation(s)
- Rabih Chattat
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Giovanni Ottoboni
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Anita Zeneli
- Nursing Service, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy
| | - Maria Alejandra Berardi
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy
| | - Veronica Cossu
- Department of Psychology, Alma Mater Studiorum-University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
| | - Marco Maltoni
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014, Meldola, Italy.
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Long-Term Treatment with Citicoline Prevents Cognitive Decline and Predicts a Better Quality of Life after a First Ischemic Stroke. Int J Mol Sci 2016; 17:390. [PMID: 26999113 PMCID: PMC4813246 DOI: 10.3390/ijms17030390] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 12/02/2022] Open
Abstract
Stroke, as the leading cause of physical disability and cognitive impairment, has a very significant impact on patients’ quality of life (QoL). The objective of this study is to know the effect of citicoline treatment in Qol and cognitive performance in the long-term in patients with a first ischemic stroke. This is an open-label, randomized, parallel study of citicoline vs. usual treatment. All subjects were selected 6 weeks after suffering a first ischemic stroke and randomized into parallel arms. Neuropsychological evaluation was performed at 1 month, 6 months, 1 year and 2 years after stroke, and QoL was measured using the EuroQoL-5D questionnaire at 2 years. 163 patients were followed during 2 years. The mean age was 67.5 years-old, and 50.9% were women. Age and absence of citicoline treatment were independent predictors of both utility and poor quality of life. Patients with cognitive impairment had a poorer QoL at 2 years (0.55 vs. 0.66 in utility, p = 0.015). Citicoline treatment improved significantly cognitive status during follow-up (p = 0.005). In conclusion, treatment with long-term citicoline is associated with a better QoL and improves cognitive status 2 years after a first ischemic stroke.
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Williams A, Sethi B, Duggleby W, Ploeg J, Markle-Reid M, Peacock S, Ghosh S. A Canadian qualitative study exploring the diversity of the experience of family caregivers of older adults with multiple chronic conditions using a social location perspective. Int J Equity Health 2016; 15:40. [PMID: 26936057 PMCID: PMC4774090 DOI: 10.1186/s12939-016-0328-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/23/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A little-studied issue in the provision of care at home by informal caregivers is the increase in older adult patients with chronic illness, and more specifically, multiple chronic conditions (MCC). We know little about the caregiving experience for this population, particularly as it is affected by social location, which refers to either a group's or individual's place/location in society at a given time, based on their intersecting demographics (age, gender, education, race, immigration status, geography, etc.). We have yet to fully comprehend the combined influence of these intersecting axes on caregivers' health and wellbeing, and attempt to do this by using an intersectionality approach in answering the following research question: How does social location influence the experience of family caregivers of older adults with MCC? METHODS The data presented herein is a thematic analysis of a qualitative sub-set of a large two-province study conducted using a repeated-measures embedded mixed method design. A survey sub-set of 20 survey participants per province (n = 40 total) were invited to participate in a semi-structured interview. In the first stage of data analysis, Charmaz's (2006) Constructivist Grounded Theory Method (CGTM) was used to develop initial codes, focused codes, categories and descriptive themes. In the second and the third stages of analysis, intersectionality was used to develop final analytical themes. RESULTS The following four themes describe the overall study findings: (1) Caregiving Trajectory, where three caregiving phases were identified; (2) Work, Family, and Caregiving, where the impact of caregiving was discussed on other areas of caregivers' lives; (3) Personal and Structural Determinants of Caregiving, where caregiving sustainability and coping were deliberated, and; (4) Finding Meaning/Self in Caregiving, where meaning-making was highlighted. CONCLUSIONS The intersectionality approach presented a number of axes of diversity as comparatively more important than others; these included gender, age, education, employment status, ethnicity, and degree of social connectedness. This can inform caregiver policy and programs to sustain health and well-being.
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Affiliation(s)
- Allison Williams
- McMaster University, School of Geography and Earth Sciences, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Bharati Sethi
- McMaster University, School of Geography and Earth Sciences, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Wendy Duggleby
- University of Alberta, Faculty of Nursing, 11405 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
| | - Jenny Ploeg
- McMaster University, School of Geography and Earth Sciences, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Maureen Markle-Reid
- McMaster University, School of Geography and Earth Sciences, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Shelley Peacock
- University of Saskatchewan, College of Nursing, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
| | - Sunita Ghosh
- University of Alberta, Faculty of Nursing, 11405 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
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Paredes AM, Landa LO, Chagualá AC, Peralta HC, Torres GV, Perrin PB, Arango-Lasprilla JC. Health-Related Quality of Life Trajectories over the First Year after Stroke in Colombia, South America. Top Stroke Rehabil 2016; 23:341-7. [DOI: 10.1080/10749357.2016.1143694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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McMurray J, McNeil H, Lafortune C, Black S, Prorok J, Stolee P. Measuring Patients' Experience of Rehabilitation Services Across the Care Continuum. Part II: Key Dimensions. Arch Phys Med Rehabil 2016; 97:121-30. [DOI: 10.1016/j.apmr.2015.08.408] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/11/2015] [Accepted: 08/03/2015] [Indexed: 12/30/2022]
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McMurray J, McNeil H, Lafortune C, Black S, Prorok J, Stolee P. Measuring Patients' Experience of Rehabilitation Services Across the Care Continuum. Part I: A Systematic Review of the Literature. Arch Phys Med Rehabil 2016; 97:104-20. [DOI: 10.1016/j.apmr.2015.08.407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/12/2015] [Accepted: 08/03/2015] [Indexed: 10/23/2022]
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Lawson S, Rowe A, Meredith YY. Survey of Stroke Caregiver Training provided by OT, PT, and SLP across Practice Settings. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2015. [DOI: 10.3109/02703181.2015.1089970] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Smith DL. Does type of disability and participation in rehabilitation affect satisfaction of stroke survivors? Results from the 2013 Behavioral Risk Surveillance System (BRFSS). Disabil Health J 2015; 8:557-63. [DOI: 10.1016/j.dhjo.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
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López-Espuela F, González-Gil T, Jiménez-Gracia MA, Bravo-Fernández S, Amarilla-Donoso J. Impacto en la calidad de vida en cuidadores de supervivientes de un ictus. ENFERMERIA CLINICA 2015; 25:49-56. [DOI: 10.1016/j.enfcli.2014.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/10/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
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Associations between quality of life and socioeconomic factors, functional impairments and dissatisfaction with received information and home-care services among survivors living at home two years after stroke onset. BMC Neurol 2014; 14:92. [PMID: 24773696 PMCID: PMC4021376 DOI: 10.1186/1471-2377-14-92] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 04/17/2014] [Indexed: 11/24/2022] Open
Abstract
Background Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors, functional impairments and self-reported dissatisfaction with received information and home-care services among survivors two years after stroke onset. This problem remains partially addressed though optimal information and services may improve survivors’ QoL. Methods Stroke-survivors admitted to all hospitals in Luxembourg 18 months or more previously were identified using the only care-expenditure-reimbursement national system database. The clinical diagnosis was confirmed. Ninety four patients aged 65 years and living at home were interviewed to gather socioeconomic characteristics, functional impairments, dissatisfaction with information and home-care services, and QoL (using the Newcastle Stroke-Specific QoL, newsqol) assessing 11 domains. Data were analyzed using multiple linear regression models. Results About 50% of survivors had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Survivors with education (<12th grade) or lower income had low values for most newsqol domains (sex-age-adjusted regression coefficient saRC, i.e. mean difference, between -23 and -8). Patients who were working had better values for pain, mental feelings and sleep domains than did retired people (saRC between -3.9 and 4.2). Various functional impairments were associated with markedly low values of nearly all domains (saRC between -33.5 and -7.5) and motor, language, memory and sensory impairments had the highest impact. The survivors’ perceived QoL was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Various QoL domains were strongly related to dissatisfaction with information about stroke and its consequences/changes over time, accuracy of information obtained, help received, coordination between services, and the possibility of receiving help when necessary (saRC reaching -30). Conclusions Stroke-survivors had major alterations in QoL that reflected depressive symptoms, which should be appropriately treated. These findings may help with the development of public policies aiming at improving QoL among stroke survivors. The newsqol could be used routinely to measure the recovery of survivors over time and their needs in terms of information, help and care services.
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Tholin H, Forsberg A. Satisfaction with care and rehabilitation among people with stroke, from hospital to community care. Scand J Caring Sci 2014; 28:822-9. [DOI: 10.1111/scs.12116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 12/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Helena Tholin
- Family Medicine Research Centre; Örebro County Council; Örebro Sweden
- Karla Primary Health Centre; Örebro County Council; Örebro Sweden
| | - Anette Forsberg
- Family Medicine Research Centre; Örebro County Council; Örebro Sweden
- School for Health and Medical Sciences; Örebro University; Örebro Sweden
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Arraras JI, Illarramendi JJ, Viudez A, Ibáñez B, Lecumberri MJ, de la Cruz S, Hernandez B, Zarandona U, Cambra K, Martinez M, Salgado E, Lainez N, Vera R. Determinants of patient satisfaction with care in a Spanish oncology day hospital and its relationship with quality of life. Psychooncology 2013; 22:2454-61. [PMID: 23733231 DOI: 10.1002/pon.3307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 04/20/2013] [Accepted: 04/24/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study evaluates satisfaction with care (SC) in cancer patients treated at a Spanish day hospital to identify SC determinants and assess the relationship between SC and quality of life. METHODS One hundred seventy-six patients with different tumour sites and disease stages completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Cancer Outpatient Satisfaction with Care questionnaire for chemotherapy (OUT-PATSAT35 CT), the Oberst patients' perception of care quality and satisfaction scales, and an item on intention to recommend the hospital. Frequencies in the SC instruments, Spearman correlations between each scale of the OUT-PATSAT35 CT and overall satisfaction and between the subscales of OUT-PATSAT35 CT and of QLQ-C30 were calculated, and the determinants of patients' SC were calculated through multivariate regression models. RESULTS Satisfaction with care was high: mean scores were >70 in all OUT-PATSAT35 CT areas except doctor availability and environment. These scores were in line with the other SC instruments. Correlation with overall satisfaction was high and statistically significant (p < 0.01) for all subscales, especially for the nurses domain, which also had higher SC scores. Correlations between the EORTC QLQ-C30 and the OUT-PATSAT35 CT were low (≤ 0.35). Younger patients and those with breast cancer showed significantly lower satisfaction in most subscales. Unmarried patients and patients that had undergone surgery reported lower satisfaction only in specific subscales. CONCLUSIONS Satisfaction with care among cancer patients treated at the day hospital is high. Nurses play a key and successful role. Age and tumour location revealed stronger relationships with SC. Correlations between SC and quality of life indicate that these concepts are complementary.
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