1
|
Storey A, Sheldrick R, Dulhanty L, Zarotti N. 'We are still here, we are survivors': patients' experiences of attending a multidisciplinary group-based support programme following subarachnoid haemorrhage. Disabil Rehabil 2024:1-9. [PMID: 39028188 DOI: 10.1080/09638288.2024.2379024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE People who survive a subarachnoid haemorrhage (SAH) often face enduring health challenges including physical disability, fatigue, cognitive impairments, psychological difficulties, and reduced quality of life. While group interventions have shown positive results in addressing similar issues in chronic conditions, the evidence involving SAH specifically is still sparse. This service evaluation aimed to explore SAH survivors' experiences of attending a multidisciplinary group-based support programme tailored to address unmet needs identified in previous literature, with the ultimate aim to refine future iterations of the programme and improve quality of care post-SAH. MATERIALS AND METHODS Semi-structured interviews were carried out with 12 individuals who attended the programme. The resulting data were analysed thematically. RESULTS Four overarching themes emerged from the analysis: (1) Barriers to accessing support after a SAH, (2) Factors acting as enablers of recovery, (3) Sharing lived experience to support one another, (4) Feeling connected while navigating a group format. CONCLUSIONS Lack of communication, fear, loneliness, and cognitive impairments can act as barriers to engagement with support, while acceptance and adjustment, holistic multidisciplinary input, and psychological support may represent successful enablers of recovery. Implications for future iterations of the programme as well as clinical rehabilitation and service development are discussed.
Collapse
Affiliation(s)
- Alice Storey
- Department of Clinical Neuropsychology, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - Russell Sheldrick
- Department of Clinical Neuropsychology, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - Louise Dulhanty
- Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - Nicolò Zarotti
- Department of Clinical Neuropsychology, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| |
Collapse
|
2
|
Delvallée M, Garreau R, Termoz A, Ploteau PM, Derex L, Schott AM, Haesebaert J. What are the available online resources targeting psychosocial burden among stroke survivors and their informal caregivers: A scoping review. Digit Health 2024; 10:20552076241240895. [PMID: 38515613 PMCID: PMC10956153 DOI: 10.1177/20552076241240895] [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] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
Background After discharge home, stroke survivors and their informal caregivers face a significant lack of support and information which accentuates their psychosocial burden. Online resources might provide this support and address psychosocial needs, but existing online stroke programmes mainly target functional rehabilitation. We aimed to map the existing literature on online resources that have been evaluated in stroke rehabilitation and aimed at reducing psychosocial impact in stroke survivors and informal caregivers. Methods MEDLINE was searched (2010-2024) to identify studies investigating online resources targeting psychosocial health. Studies were selected and extracted independently by two reviewers. We described the content, use, and psychosocial impact of these interventions using a narrative approach. Results Eleven studies were included in the review, reporting 10 online resources (two studies relating to the same resource). Online resources were heterogeneous: eight information/resources websites, one mobile app, and one forum. Five online resources were dedicated to stroke survivors, four to stroke survivors and their informal caregivers, and one to informal caregivers. Two randomized controlled trials reported a significant decrease in depressive symptoms associated with the use of online resources. Stroke survivors and informal caregivers find online resources useful and acceptable to address their psychosocial needs. Conclusions Few online stroke resources have been designed and evaluated to support post-stroke psychosocial rehabilitation. Further larger-scale research needs to study the impact of these interventions on psychosocial recovery over time.
Collapse
Affiliation(s)
- Marion Delvallée
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Romain Garreau
- Pharmacy Department, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Université Claude Bernard Lyon 1, Lyon, France
| | - Anne Termoz
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Pierre-Marie Ploteau
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Laurent Derex
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Service Neuro-vasculaire, Hospices Civils de Lyon, Hôpital Pierre Wertheimer, Lyon, France
| | - Anne-Marie Schott
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle de Sante Publique, Lyon, France
| |
Collapse
|
3
|
Stagg K, Douglas J, Iacono T. Living with stroke during the first year after onset: an instrumental case study exploring the processes that influence adjustment. Disabil Rehabil 2023; 45:3610-3619. [PMID: 36222354 DOI: 10.1080/09638288.2022.2131005] [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: 05/04/2022] [Accepted: 09/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of the study was to explore the experiences of an individual navigating life in the first year after stroke, with attention to the influence of health professionals on adjustment. METHOD In-depth interviews were completed at regular intervals with an individual in rural Australia. This longitudinal approach supported the exploration of views over time. Interview transcripts were coded and analysed using strategies consistent with constructivist grounded theory methods. Findings are presented as an instrumental case study. RESULTS The experience of stroke was one of adjustment to a new reality and of an altered and evolving concept of self: captured within the themes of fragmentation, loss, and reconstruction. Self-efficacy emerged as a driver in the adjustment process. Interactions with health professionals influenced adjustment and impacted on conceptualisations of self and self-efficacy. CONCLUSIONS Adjustment to stroke necessitated a reconceptualization of self. Relationships and interactions with others emerged as potential facilitators. For health professionals working with people after stroke, knowledge of the adjustment process and attention to practices that affirm personhood and enhance self-efficacy have the potential to facilitate long term outcomes. Processes linked to adjustment are represented visually to guide conceptual understandings and facilitative actions. IMPLICATIONS FOR REHABILITATIONAll interactions with health professionals, including casual or ad hoc interactions, have the potential to influence adjustment after stroke.Health professionals who interact in ways that recognise personhood may have an especially positive influence on processes linked to adjustment.Giving time to listen to personal narratives and reflections may assist with sense-making and support the process of reconceptualising self after stroke.Through bidirectional sharing of experience and ideas, health professionals can facilitate the experience of self-efficacy.
Collapse
Affiliation(s)
- Kellie Stagg
- Living with Disability Research Centre, La Trobe University, Melbourne/Bendigo, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne/Bendigo, Australia
- Summer Foundation, Melbourne, Australia
| | - Teresa Iacono
- Living with Disability Research Centre, La Trobe University, Melbourne/Bendigo, Australia
| |
Collapse
|
4
|
Lamont RA, Calitri R, Mounce LTA, Hollands L, Dean SG, Code C, Sanders A, Tarrant M. Shared social identity and perceived social support among stroke groups during the COVID-19 pandemic: Relationship with psychosocial health. Appl Psychol Health Well Being 2022; 15:172-192. [PMID: 35139581 PMCID: PMC9111261 DOI: 10.1111/aphw.12348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
Community-based peer support groups for stroke survivors are common in the United Kingdom and aim to support rehabilitation. This study of 260 stroke survivors across 118 groups nationally used an online survey format, completed on average 3 months into the pandemic. Analysis of both quantitative and open-ended responses provided insights into how stroke group members maintained contact during the COVID-19 pandemic and how the group processes of shared social identity and perceived social support related to psychosocial outcomes (self-esteem, well-being and loneliness). Group members adapted to the pandemic early through telephone calls (61.6% of participants) and internet-based contact (>70% of participants), although also showed a desire for greater contact with their groups. A stronger sense of shared social identity and perceptions of social support from the stroke groups were weakly associated with reductions in loneliness among members, and greater perceived social support was associated with higher self-esteem. However, having poor health and living alone were more strongly associated with more negative psychosocial outcomes. The discussion considers how barriers to contact during pandemics can be managed, including access and use of online communication, limitations imposed by stroke-related disability, and how the experience of feeling supported and social identification can be better nurtured within remote contexts.
Collapse
Affiliation(s)
- Ruth A. Lamont
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Raff Calitri
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - Laura Hollands
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Sarah G. Dean
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Chris Code
- Department of PsychologyUniversity of ExeterExeterUK
| | - Amy Sanders
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Mark Tarrant
- College of Medicine and HealthUniversity of ExeterExeterUK
| |
Collapse
|
5
|
Hu R, Wang X, Liu Z, Hou J, Liu Y, Tu J, Jia M, Liu Y, Zhou H. Stigma, depression, and post-traumatic growth among Chinese stroke survivors: A longitudinal study examining patterns and correlations. Top Stroke Rehabil 2020; 29:16-29. [PMID: 33371827 DOI: 10.1080/10749357.2020.1864965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: With the development of positive psychology, several studies show that positive and negative emotions are not always opposing. Understanding how positive and negative emotions correlate and the factors contributing to resilience in stroke survivors requires further research.Objectives: To identify the patterns and correlations of stigma, depression, and posttraumatic growth (PTG) among stroke survivors.Methods: Stroke-related stigma, depression, PTG, and neurological status were evaluated at 1-month and 3 months post-stroke using the Stroke Stigma Scale (SSS), Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Posttraumatic Growth Inventory (C-PTGI), modified Rankin Scale (mRS), and Social Support Rating Scale (SSRS). The paired t-test, nonparametric test, and Spearman's correlation test were used to analyze differences and relationships between results at the two time points.Results: At 3 months compared to 1-month post-stroke, we found significant reductions in mRS and stigma scores, and an increase in PTGI scores, while the PHQ-9 scores reduced non-significantly. SSS, PHQ-9, and mRS scores were positively correlated with each other at time1 (all P < .01), and all showed no significant relationships with PTGI scores (all P > .05). Social support scores were negatively correlated with stigma (P < .01), PHQ-9 (P < .01), and PTGI scores (P > .05) at 3 months.Conclusions: Stroke-related stigma is strongly associated with depression while neither of them has significant relationships with PTG during the early stage of survivors' rehabilitation in our study. Neurological impairment is a risk factor for negative emotions and increasing individualized support may reduce stigma, depression, and promote PTG in the long term.
Collapse
Affiliation(s)
- Ruidan Hu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoyan Wang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhihong Liu
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, China
| | - Jiakun Hou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yangyang Liu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinyi Tu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Miao Jia
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue Liu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongzhen Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|