1
|
Duong A, Roberts L, Cramm H, Evans MB, Mayhew E, Latimer-Cheung AE, Aiken A, Shirazipour CH. I AM FAMILY: Understanding the adapted sport experiences of family members of military personnel with physical and psychological illnesses and injuries through the lens of the Invictus Games. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 68:102457. [PMID: 37665901 DOI: 10.1016/j.psychsport.2023.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 09/06/2023]
Abstract
Family are influential actors in adapted sport participation. However, little is known about their experiences with adapted sport. The current study sought to explore the experiences of families in adapted sport through the context of the Invictus Games, an international adapted sport competition for military personnel with physical and psychological illnesses and injuries that is unique in its inclusion of family programming. Family members (n = 21; partners, parents, siblings, and children) of Invictus Games Toronto 2017 competitors participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Three themes were identified: recognition of family experiences during service and after onset of disability; creating a sense of belonging; and improving family knowledge and perceptions. This study provides insight regarding how adapted sport events can support the well-being of both individuals with illnesses and injuries and their families.
Collapse
Affiliation(s)
- Amber Duong
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; School of Medicine, University of California Irvine, Irvine, USA
| | - Lauren Roberts
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - M Blair Evans
- Department of Psychology, Western University, London, Canada
| | - Emily Mayhew
- Department of Bioengineering, Imperial College London, London, UK
| | | | - Alice Aiken
- School of Physiotherapy, Dalhousie University, Halifax, Canada
| | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
| |
Collapse
|
2
|
Madden EB, Bislick L, Wallace SE, Therrien MCS, Goff-Albritton R. Aphasia and friendship: Stroke survivors' self-reported changes over time. JOURNAL OF COMMUNICATION DISORDERS 2023; 103:106330. [PMID: 37105058 DOI: 10.1016/j.jcomdis.2023.106330] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/23/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Friendships are an important contributor to quality of life. Due to communication and other stroke-related challenges, people with aphasia (PWA) can experience negative friendship changes, which have been linked with increased physiological distress. This study examined friendship experiences over time for PWA to understand how friendships evolve throughout the course of stroke and aphasia recovery. METHODS Fifteen stroke survivors with chronic aphasia completed language testing and a friendship questionnaire created by the researchers. The friendship questionnaire was composed of open and closed-ended questions that asked PWA to reflect back on their friendship satisfaction, support, activities, and communication during the time before aphasia and during the acute stage of recovery. The questionnaire also addressed their current friendships in the present-day chronic stage of recovery, as well as questions about an ideal friendship. Quantitative and qualitative methods were used to examine the data, with quantitative findings reported in this study. RESULTS The majority of PWA reported maintaining some friendships and developing new friendships, often with a fellow stroke survivor with aphasia; however, a few PWA in this study were not able to maintain or develop any new friendships. Average ratings of perceived friendship satisfaction and support improved from the acute to chronic stage, nearing those of the ratings pre-stroke, yet there was greater variability in the chronic stage with some currently feeling dissatisfied and not well supported. Aphasia severity, as measured by a standardized assessment, had a negative relationship with perceived friendship support. In contrast, perception of communicative participation had a positive relationship with friendship support. CONCLUSIONS This work highlights lasting social implications of aphasia. The overall health of PWA deserves greater attention, including interventions targeting friendship maintenance and development. Continued stakeholder-engaged research and clinical practice focused on the social and emotional consequences of aphasia on PWA, as well as their friends and family, is needed to assist all involved in aphasia recovery achieve better friendships and well-being.
Collapse
Affiliation(s)
- Elizabeth B Madden
- School of Communication Science and Disorders, Florida State University, United States.
| | - Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, United States
| | - Sarah E Wallace
- Department of Communication Science and Disorders, University of Pittsburgh, United States
| | - Michelle C S Therrien
- School of Communication Science and Disorders, Florida State University, United States
| | | |
Collapse
|
3
|
Bradshaw J, Siddiqui N, Greenfield D, Sharma A. Kindness, Listening, and Connection: Patient and Clinician Key Requirements for Emotional Support in Chronic and Complex Care. J Patient Exp 2022; 9:23743735221092627. [PMID: 35434291 PMCID: PMC9008851 DOI: 10.1177/23743735221092627] [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] [Indexed: 11/16/2022] Open
Abstract
Emotional support for patients is critical for achieving person-centered care. However, the literature evidences an ongoing challenge in embedding emotional support within current health services. This study aimed to investigate the strategies to embed emotional support from the perspectives of patients and clinicians. This is an exploratory qualitative study that collected data through focus group discussions (FGDs) and interviews from 11 patients, 2 carers, and 7 clinicians in the multi-disciplinary care teams in an outpatient complex and chronic care setting in New South Wales, Australia. The FGDs and interviews were recorded, transcribed, and thematically analyzed. Three main themes emerged from the experience of both the patients and clinicians: (1) warmth and kindness, (2) deep listening, and (3) social connection in the process of treatment. Clinicians' and patients' shared experience of these themes was key to embed emotional support in care. Practical strategies including promoting shared understanding of emotional support, enhancing provider's capability to deliver emotional support, and building patient's networking opportunities in treatment processes were discussed to facilitate emotional support in patient care and health services.
Collapse
Affiliation(s)
- Jane Bradshaw
- University of Tasmania, Health Service Management School of Business & Economics, Sydney,
Australia
- Be Pain Smart Service, Royal Rehab, Ryde, Australia
| | - Nazlee Siddiqui
- University of Tasmania, Health Service Management School of Business & Economics, Sydney,
Australia
| | - David Greenfield
- UNSW Simpson Centre for Health Services
Research, Sydney, Australia
- University of New South Wales Southwestern Sydney
Clinical School, Liverpool, Australia
| | - Anita Sharma
- Nepean Blue Mountains Local Health
District, Western Sydney, Australia
- Nepean Clinical School, University of Sydney, Sydney, Australia
| |
Collapse
|
4
|
Northcott S, Simpson A, Thomas S, Barnard R, Burns K, Hirani SP, Hilari K. "Now I Am Myself": Exploring How People With Poststroke Aphasia Experienced Solution-Focused Brief Therapy Within the SOFIA Trial. QUALITATIVE HEALTH RESEARCH 2021; 31:2041-2055. [PMID: 34130554 PMCID: PMC8552370 DOI: 10.1177/10497323211020290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Aphasia, a language disability, can profoundly affect a person's mood and identity. The experiences of participants who received Solution-Focused Brief Therapy, a psychological intervention, were explored in the Solution-Focused brief therapy In poststroke Aphasia (SOFIA) Trial. Thirty participants with chronic aphasia, 14 with severe aphasia, participated in in-depth interviews that were analyzed using framework analysis. Two overarching themes emerged: valued therapy components (exploring hopes, noticing achievements, companionship, sharing feelings, and relationship with therapist) and perceptions of progress (mood, identity, communication, relationships, and independence). Participants were categorized into four groups: (a) "changed," where therapy had a meaningful impact on a person's life; (b) "connected," where therapy was valued primarily for companionship; (c) "complemental," where therapy complemented a participant's upward trajectory; and (d) "discordant," where therapy misaligned with participants' preference for impairment-based language work. This study suggests that it is feasible to adapt a psychological therapy for people with aphasia, who perceive it as valuable.
Collapse
Affiliation(s)
| | | | | | | | - Kidge Burns
- Expert Independent Practitioner, London, United Kingdom
| | | | | |
Collapse
|
5
|
Martinsen R, Kitzmüller G, Mangset M, Kvigne K, Evju AS, Bronken BA, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Nurses' and occupational therapists' experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation. BMC Health Serv Res 2021; 21:791. [PMID: 34376188 PMCID: PMC8356405 DOI: 10.1186/s12913-021-06857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to assist the persons and their families during the recovery and adjustment process. A home-based dialogical intervention aiming to enhance psychosocial support was therefore developed and tested in a randomized controlled trial. This study is a part of the process evaluation conducted alongside the trial. The aim was to explore the nurses’ and occupational therapists’ experiences of conducting the intervention. Methods Eighteen nurses and four occupational therapists participated in six focus groups to explore their experiences when providing the intervention. The themes discussed in the focus groups were the aspects that facilitated the delivering of the intervention and the challenges they encountered during the study period. The interviews were analysed using qualitative content analysis. Results The analysis generated two themes. The theme Developing a supportive relationship to facilitate the adjustment process following stroke had two subthemes: Getting personally involved and Handling challenges. This theme reveals how the nurses and occupational therapists experienced their relationship with the persons with stroke and potential threats which challenged them while conducting the intervention. The theme Developing professional skills in providing psychosocial support had two subthemes: Becoming confident in conducting dialogues and Integrating psychosocial topics. This theme reveals the aspects that the nurses and occupational therapists perceived as facilitating the development of their professional skills in conducting the dialogues. Conclusion Delivering the psychosocial intervention was perceived as deeply meaningful and increased the nurses’ and occupational therapists’ understanding of how to support stroke survivors to live with the consequences of stroke. However, balancing the professional and the personal relationship was challenging. A basic educational programme, training, supervision and having dedicated time were crucial elements to instil confidence in professionals conducting theme-based dialogues to promote post-stroke psychosocial well-being. Individual clinical experience and knowledge of stroke care were considering important to enable professionals to integrate psychosocial rehabilitation into community health care. Trial registration ClinicalTrials.gov, NCT 02338869, registered 10/04/2014.
Collapse
Affiliation(s)
- Randi Martinsen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway.
| | - Gabriele Kitzmüller
- Department of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Kari Kvigne
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway
| | - Anne Svelstad Evju
- Department of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø, Norway
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway
| | - Line Kildal Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Geriatric Medicine and Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
6
|
The experience of close personal relationships after stroke: scoping review and thematic analysis of qualitative literature. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background and Purpose:
Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.
Method:
Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.
Results:
While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.
Conclusions:
Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.
Collapse
|
7
|
Zhao Y, Hu B, Liu Q, Wang Y, Zhao Y, Zhu X. Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms. Int J Nurs Pract 2021; 28:e12939. [PMID: 33870617 DOI: 10.1111/ijn.12939] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/09/2021] [Accepted: 03/17/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Research has demonstrated that higher social support is associated with better psychological health, quality of life, cognition, activities of daily living and social participation, but the relationship between social support and sleep quality remains unknown. AIMS This study aimed to assess the incidence of poor sleep quality, clarify the relationship between social support and sleep quality amongst stroke patients and determine whether anxiety and depression symptoms mediate this relationship. METHODS We conducted a quantitative, cross-sectional study involving 238 patients with stroke (median age of 61 [range 29-87] years, 68.1% male) recruited from a comprehensive tertiary care hospital between September 2019 and January 2020. A self-administered, structured questionnaire was used for the survey. The mediating effect of anxiety and depression symptoms was assessed using the bootstrap method via Model 4 (parallel mediation) of the SPSS PROCESS macro. RESULTS Results showed that the incidence of poor sleep quality amongst stroke patients was 65%. Mediation analysis showed that social support exerted significant direct effects on sleep quality, and anxiety and depression symptoms mediated the relationship between social support and sleep quality. CONCLUSION Measures should be taken to enhance social support to improve the sleep quality of stroke patients. SUMMARY STATEMENT What is already known about this topic? Patients with stroke have a high rate of sleep disorders, anxiety and depression symptoms. Anxiety and depression symptoms have a negative effect on sleep quality. Social support may be an effective intervention to reduce anxiety and depression symptoms and improve sleep quality amongst stroke patients. What this paper adds? The incidence of poor sleep was high amongst stroke patients. Social support had a direct positive effect on sleep quality. Anxiety and depression symptoms played multiple mediating roles in the relationship between social support and sleep quality. The implications of this paper: Our study adds to the existing literature by clarifying how social support impacts the sleep quality of stroke patients. We suggested improving the sleep quality of stroke patients through enhancing social support and reducing anxiety and depression symptoms, especially in patients with low levels of social support.
Collapse
Affiliation(s)
- Yaling Zhao
- School of Nursing, Department of Medicine, Qingdao University, Qingdao, China
| | - Bo Hu
- Department of Thoracic Surgery, Municipal Hospital, Qingdao, China
| | - Qingwei Liu
- School of Nursing, Department of Medicine, Qingdao University, Qingdao, China
| | - Ying Wang
- School of Nursing, Department of Medicine, Qingdao University, Qingdao, China
| | - Yuxue Zhao
- School of Nursing, Department of Medicine, Qingdao University, Qingdao, China
| | - Xiuli Zhu
- School of Nursing, Department of Medicine, Qingdao University, Qingdao, China
| |
Collapse
|
8
|
Kitzmüller G, Mangset M, Evju AS, Angel S, Aadal L, Martinsen R, Bronken BA, Kvigne K, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Finding the Way Forward: The Lived Experience of People With Stroke After Participation in a Complex Psychosocial Intervention. QUALITATIVE HEALTH RESEARCH 2019; 29:1711-1724. [PMID: 30862270 DOI: 10.1177/1049732319833366] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Stroke patients' well-being is threatened after stroke. A psychosocial intervention was developed for Norwegian stroke patients living in the community. Eight individual sessions between people with stroke and a trained health care professional were conducted 1 to 6 months post-stroke with one group of participants and 6 to 12 months post-stroke with another group. Subsequently, 19 of these stroke patients were interviewed to gain an in-depth understanding of their lived experience of the influence of the intervention on their adjustment process. Interview texts were analyzed using Ricoeur's interpretation theory. Two participants did not personally find the intervention useful. The remaining participants greatly appreciated dialogues with the empathetic intervention personnel, feeling free to discuss their fears and worries. The intervention raised these participants' awareness of their needs and resources. They were guided to resume their everyday life and adopt a future-oriented attitude. The intervention facilitated their meaning-making endeavors and post-stroke adjustment.
Collapse
Affiliation(s)
| | | | - Anne S Evju
- UiT The Arctic University of Norway, Narvik, Norway
| | - Sanne Angel
- Aarhus University, Aarhus, Denmark
- Molde University College, Molde, Norway
| | - Lena Aadal
- Aarhus University, Aarhus, Denmark
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, Elverum, Norway
| | - Berit A Bronken
- Inland Norway University of Applied Sciences, Elverum, Norway
| | - Kari Kvigne
- Inland Norway University of Applied Sciences, Elverum, Norway
- Nord University, Sandnessjøen, Norway
| | - Line K Bragstad
- Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
| | | | - Unni Sveen
- Oslo University Hospital, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
| | | |
Collapse
|