Key informants' perspectives on implementing caregiver programs in an organized system of stroke care

The acceptance and attitudes towards using assistive technology for people with stroke in Jordan: caregivers' perspectives

The aim of this study is to evaluate the acceptance and attitudes toward assistive technology (AT) for people with stroke from their caregivers' perspectives in Jordan. Also, this study further validates the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. This is a cross-sectional study that includes a three-sections survey: the first section contains demographic data, the second section includes the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire, and the third section consists of two optional open-ended questions. Among 123 caregivers of people with stroke over 18 years of age who participated in this study, 23% were male. The findings indicate a moderate to high acceptance of using AT for stroke survivors, confirm the validity and reliability of the UTAUT questionnaire, and clarify novel issues regarding AT based on the caregivers' perspectives.

Utilization of social media communities for caregiver information support in stroke recovery: An analysis of content and interactions

Background

Caregivers often use the internet to access information related to stroke care to improve preparedness, thereby reducing uncertainty and enhancing the quality of care.

Method

Social media communities used by caregivers of people affected by stroke were identified using popular keywords searched for using Google. Communities were filtered based on their ability to provide support to caregivers. Data from the included communities were extracted and analysed to determine the content and level of interaction.

Results

There was a significant rise in the use of social media by caregivers of people affected by stroke. The most popular social media communities were charitable and governmental organizations with the highest user interaction–this was for topics related to stroke prevention, signs and symptoms, and caregiver self-care delivered through video-based resources.

Conclusion

Findings show the ability of social media to support stroke caregiver needs and practices that should be considered to increase their interaction and support.

Family caregiving research: Reflecting on the past to inform the future

OBJECTIVE

Family caregiving research has evolved since its inception in the late 1970s. The objective of this brief report was to summarize the research areas and findings to date with the goal of highlighting directions for future research.

DESIGN

Narrative review.

SETTING

Not applicable.

PARTICIPANTS

Published scientific articles in neurological populations including spinal cord injury, traumatic brain injury, and stroke.

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Not applicable.

RESULTS

Caregiving research began with a description of the impact of providing care on caregiver health and wellbeing. Intervention research followed to support caregivers in their role and improve caregiving outcomes. Recent reviews conclude a "one size fits all" intervention will not be sufficient to support caregivers. New research suggests caregivers have different patterns of adjustment to the caregiving role highlighting heterogeneity in the caregiving population. Research is also advancing to support patients and families as they transition across care environments by enhancing the timing of intervention delivery. Health care systems do not routinely adopt evidence-based caregiver interventions. As a result, recent research has begun to identify factors that influence the adoption of evidence-based caregiver interventions by health care systems. Ultimately, family centered care that addresses the needs of not only the patient but also the caregiver may be the best way to meet the needs of a heterogeneous group of caregivers across the care continuum.

CONCLUSIONS

Family caregivers make an important contribution to the health and wellbeing of individuals with spinal and other neurological conditions. Ultimately, system changes, like family centered care, may be best suited to meet the complex needs of this heterogeneous group of caregivers.

A Qualitative study assessing organisational readiness to implement caregiver support programmes in Ontario, Canada

OBJECTIVE

To qualitatively explore factors affecting implementation of caregiver support programmes in healthcare institutions in a regional stroke system.

DESIGN

A qualitative descriptive study with the Ontario Stroke System (OSS) was conducted. Data were collected through focus groups and in-depth interviews. Transcripts were coded and analysed using inductive thematic analysis.

SETTING

Regional Stroke System, Ontario, Canada.

PARTICIPANTS

OSS stakeholders including medical directors, executives, programme directors, education coordinators, rehabilitation and community and long-term care specialists, primary care leaders and healthcare professionals.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Data collection explored perceptions of the need for caregiver support programmes and factors that may affect their implementation.

RESULTS

Four focus groups (n=43) and 29 interviews were completed. Analyses identified themes related to (1) evidence that a caregiver programme will improve health and health system outcomes, (2) personnel requirements, (3) barriers associated with current billing and referral processes and (4) integration with current practice and existing workflow processes.

CONCLUSIONS

Implementation strategies to adopt caregiver programmes into clinical practice should incorporate evidence and consider personnel and existing workflow processes.

Quality of life after stroke rehabilitation discharge: a 12-month longitudinal study

PURPOSE

To analyse trends in quality of life (QoL) development among older stroke patients within the first year after rehabilitation discharge, and to investigate the impact of including proxy interviews in research and practice.

METHODS

A prospective cohort study with follow-up at 3, 6, and 12 months with 411 patients and proxy respondents was conducted. The EUROHIS-QOL 8-item index was used to assess QoL. By performing descriptive analyses, QoL development over time was compared among subgroups. Linear mixed models were calculated to estimate mean changes from baseline to 12-month follow-up. The effects of patient characteristics and time on QoL were investigated using comprehensive mixed models.

RESULTS

One year after rehabilitation discharge, the majority of patients had neither maintained nor regained their initial QoL. Proxy respondents reported significantly lower QoL (22.6-29.5 points, p < 0.001). Characteristics associated with lower QoL were stroke severity, depression, and pain. Having a small social network was negatively associated with QoL (-1.66 points, 95%CI: -2.84/-0.48, p = 0.006).

CONCLUSIONS

Quality of life scores reported at the time of rehabilitation discharge are often not lasting. Including severely impaired patients via proxies reduces the risk of overestimating QoL outcomes. Outpatient's characteristics should be taken into account when planning therapy strategies to maintain previously achieved health goals. Regular re-assessments are required.Implications for rehabilitationThere should be an awareness that improvements in quality of life (QoL) achieved during rehabilitation are not sustainable.Regularly re-assessing pain status, psychological burden, and social network size could help clinicians to determine treatment strategies for maintaining and improving rehabilitation achievements.Conducting proxy interviews is required to assess disease burden of patients with severe stroke (e.g., non-linguistic patients).