1
|
Šaňáková Š, Gurková E, Štureková L, Bartoníčková D, Machálková L, Mazalová L. How to return? experiences of patients in working age after first Ischaemic stroke: an interpretative phenomenological analysis of patient´s perspective at 12 - 24 months post-stroke. Int J Qual Stud Health Well-being 2024; 19:2398249. [PMID: 39229807 PMCID: PMC11376287 DOI: 10.1080/17482631.2024.2398249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Limited evidence of young adult patient-reported outcomes and experiences after ischaemic stroke has been conducted. AIM To investigate the meaning of the lived experiences of stroke patients in working age 12-24 months after their first IS. MATERIAL AND METHODS The exploratory qualitative study used an interpretative phenomenological analysis (IPA) design. Nine ischaemic stroke patients (with age ranges from 41 to 50 years) took part in semi-structured qualitative interviews. RESULTS Even with mild residual neurological deficit, IS negatively impacted the quality of life daily and social life. Six subthemes and three interconnected group experiential themes were generated: (i) From confusion to understanding (ii) Triggers for rebuilding; and (iii) Challenges and benefits. CONCLUSION The study highlights the current gaps and limitations in supporting the needs of stroke patients in working age in long-term post-stroke care. The findings are crucial for healthcare professionals to develop improved age- and mild- impairment-appropriate strategies or tailor self-management interventions for stroke patients of working age.ClinicalTrials.gov: NCT04839887.
Collapse
Affiliation(s)
- Šárka Šaňáková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Štureková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Machálková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Mazalová
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| |
Collapse
|
2
|
Ignacio KHD, Muir RT, Diestro JDB, Singh N, Yu MHLL, Omari OE, Abdalrahman R, Barker-Collo SL, Hackett ML, Dukelow SP, Almekhlafi MA. Prevalence of depression and anxiety symptoms after stroke in young adults: A systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2024; 33:107732. [PMID: 38657829 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107732] [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: 02/06/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Young adults with stroke have distinct professional and social roles making them vulnerable to symptoms of post-stroke depression (PSD) and post-stroke anxiety (PSA). Prior reviews have examined the prevalence of anxiety and depression in stroke populations. However, there are a lack of studies that have focused on these conditions in young adults. OBJECTIVE We performed a systematic review and meta-analysis of observational studies that reported on symptoms of PSD, PSA and comorbid PSD/PSA in young adults aged 18 to 55 years of age. METHODS MEDLINE, EMBASE, SCOPUS and PsycINFO were searched for studies reporting the prevalence of symptoms of PSD and/or PSA in young adults with stroke from inception until June 23, 2023. We included studies that evaluated depression and/or anxiety symptoms with screening tools or interviews following ischemic or hemorrhagic stroke. Validated methods were employed to evaluate risk of bias. RESULTS 4748 patients from twenty eligible studies were included. Among them, 2420 were also evaluated for symptoms of PSA while 847 participants were evaluated for both PSD and PSA symptoms. Sixteen studies were included in the random effects meta-analysis for PSD symptoms, with a pooled prevalence of 31 % (95 % CI 24-38 %). Pooled PSA symptom prevalence was 39 % (95 % CI 30-48 %) and comorbid PSD with PSA symptom prevalence was 25 % (95 % CI 12-39 %). Varying definitions of 'young adult', combinations of stroke subtypes, and methods to assess PSD and PSA contributed to high heterogeneity amongst studies. CONCLUSIONS We identified high heterogeneity in studies investigating the prevalence of symptoms of PSD and PSA in young adults, emphasizing the importance of standardized approaches in future research to gain insight into the outcomes and prognosis of PSD and PSA symptoms following stroke in young adults. Larger longitudinal epidemiological studies as well as studies on tailored interventions are required to address the mental health needs of this important population. FUNDING None.
Collapse
Affiliation(s)
- Katrina Hannah D Ignacio
- Department of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada.
| | - Ryan T Muir
- Department of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - Jose Danilo B Diestro
- Department of Medical Imaging, Division of Diagnostic and Therapeutic Neuroradiology, St Michael's Hospital, University of Toronto, Ontario, Canada
| | - Nishita Singh
- Neurology division, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | | | | | - Maree L Hackett
- University of New South Wales, Sydney, Australia; The School of Nursing and Midwifery, The University of Central Lancashire, Preston, United Kingdom
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Mohammed A Almekhlafi
- Department of Clinical Neurosciences, Calgary Stroke Program, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Alberta, Canada
| |
Collapse
|
3
|
Bright L, Wei TZ, Lau SCL, Baum CM. An Exploratory Study of Young Stroke Survivors' Lived Experiences: A Multi-Methods Study Using Developmental Theory. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:405-413. [PMID: 37649450 DOI: 10.1177/15394492231196783] [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: 09/01/2023]
Abstract
Young adults make up 10% of strokes that occur in the United States each year. Little research has shown the developmental and occupational disruption as a result of stroke for this population. The objective of this study was to describe young stroke survivors' perceived disruptions using developmental theory. A multiple methods study was conducted with community-dwelling stroke survivors between the ages of 18 and 40 using Patient-Reported Outcomes Measurement Information System (PROMIS) measures and qualitative interviews. Five themes were reported from the qualitative data: stroke and health, work and school, romantic relationships, parenting, and other social relationships. PROMIS measure results were not significantly different from the normed population despite challenges revealed during qualitative interviews. Qualitative data showed variations in post-stroke deficits and occupational performance that could not be meaningfully captured by the PROMIS measures alone. Occupational therapy practitioners should use developmental theory to guide their understanding of occupational disruptions in young stroke survivors.
Collapse
Affiliation(s)
- Lindsay Bright
- Washington University School of Medicine, St. Louis, MO, USA
| | | | - Stephen C L Lau
- Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Washington University School of Medicine, St. Louis, MO, USA
- Washington University in St. Louis, MO, USA
| |
Collapse
|
4
|
Bartoníčková D, Gurková E, Zeleníková R, Kalafutová S. Return to work after ischaemic stroke in young adults: a scoping review. Cent Eur J Public Health 2024; 32:108-118. [PMID: 39069314 DOI: 10.21101/cejph.a7936] [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: 06/21/2023] [Accepted: 05/12/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES The aim of the study was to synthesize the body of knowledge on the factors that are important to the process of returning to work after ischaemic stroke in young adults under 55 years of age. METHODS Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA checklist for scoping reviews were used. A total of 2,249 studies were identified through a bibliographic search in six databases. RESULTS A total of ten studies were finally selected to respond to the research questions. Eight studies were quantitative observational studies, and two studies had a case study design. The rate of returning to work varied between the studies. The frequency of returning to work in young stroke patients, independent of the time of assessment, ranged from 42.4% to 86%. Returning to work after ischaemic stroke in young adults is a complex process and multidimensional problem which is affected by clinical variables (level of neurological deficits, cognitive ability, independency in activities of daily living, fatigue and depression, cardiovascular factors), as well as the socioeconomic and occupational status. CONCLUSION There is insufficient evidence concerning interventions promoting return to work. Future studies should focus on examining effective interventions to help young stroke survivors return to work.
Collapse
Affiliation(s)
- Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Soňa Kalafutová
- Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Presov, Presov, Slovak Republic
| |
Collapse
|
5
|
Shaik MA, Choo PY, Tan-Ho G, Lee JCK, Ho AHY. Recovery needs and psychosocial rehabilitation trajectory of stroke survivors (PReTS): A qualitative systematic review of systematic reviews. Clin Rehabil 2024; 38:263-284. [PMID: 37933440 DOI: 10.1177/02692155231207265] [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: 11/08/2023]
Abstract
OBJECTIVE Stroke has a major impact on a person's life. While much research exists on stroke prevention and treatment, explorations into psychosocial recovery needs are lacking. This review critically consolidates the challenges and needs of stroke survivors and develops a trajectory that encapsulates their journey from illness to recovery. DATA SOURCES Six major databases were searched, including Academic Search Premier, CINAHL, Global Health, Medline, PsycArticles, and PsycINFO. METHODS This review adhered to the PRISMA guidelines and employed the PICo (population, phenomena of interest, context) framework to screen for relevant qualitative reviews published between 1 January 2010 and 31 August 2023. Following full-text screening and the assessment of methodological quality using a modified version of the Assessment of Multiple Systematic Reviews scale, a total of 17 reviews were included for thematic synthesis. RESULTS Included reviews referenced 400 qualitative primary studies involving more than 5623 stroke survivors. Data synthesis revealed 18 themes that were further organized into six conceptual categories: (1) The unfamiliar body, (2) compassionate healthcare system, (3) holistic rehabilitation, (4) intrapersonal strength, (5) interpersonal relations, and (6) thriving forward to form the psychosocial rehabilitation trajectory of stroke survivor (PReTS) model. The model recognizes the losses that can occur after a stroke and emphasizes the essentiality of addressing psycho-socio-emotional and spiritual needs alongside physical impairments. CONCLUSION The PReTS model is the first to highlight stroke survivors' losses, recovery journeys, and psychosocial needs. The conceptualization serves to inform and advance stroke rehabilitation practices with holistic and wellness recovery research.
Collapse
Affiliation(s)
- Muhammad Amin Shaik
- Psychology Programme, Nanyang Technological University, Singapore, Singapore
| | - Ping Ying Choo
- Psychology Programme, Nanyang Technological University, Singapore, Singapore
| | - Geraldine Tan-Ho
- Psychology Programme, Nanyang Technological University, Singapore, Singapore
| | - Jimmy Chee-Keong Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Institute of Mental Health, Singapore, Singapore
| | - Andy Hau Yan Ho
- Psychology Programme, Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- The Palliative Care Centre for Excellence in Education and Research (PalC), Singapore, Singapore
| |
Collapse
|
6
|
Gawulayo S, Erasmus CJ, Rhoda AJ. Family functioning and stroke: Family members' perspectives. Afr J Disabil 2021; 10:801. [PMID: 34858798 PMCID: PMC8603059 DOI: 10.4102/ajod.v10i0.801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/10/2021] [Indexed: 11/20/2022] Open
Abstract
Background Stroke survivors often experience permanent or temporal physical and psychological stroke impairments. As a result, stroke survivors are often discharged to recover in their home environments and are cared for mostly by family members. Additionally, caregiving roles are often assumed without any formal training or preparation whatsoever. This can transform the family’s functional patterns due to adjustments that are made to accommodate the caregiving needs. Objectives To explore the experiences and influence of stroke on families and on family functioning. Method Explorative descriptive qualitative research design through the use of in-depth interviews were employed as the means of data collection. The sample size was eight (8) family members and was guided by the saturation point. Data was thematically analysed. Results Four themes emerged from the analysis: 1) reduced interactions with family members due to communication barriers, 2) the influence of stroke on family relationships, 3) emotional engagement in caring for a family member with a stroke and 4) financial implications of stroke on family functioning. This study found that stroke can influence the family functioning negatively as family members may be forced to change their functional patterns. However, some family members reported positive experiences, they developed a supportive structure to accommodate the new life of the stroke survivor. Conclusion Using the McMaster’s model of family functioning, this study found that stroke is a threat to the six dimensions of family functioning: 1) problem-solving, 2) communication, 3) roles, 4) affective responsiveness, 5) affective involvement, and 6) behaviour control.
Collapse
Affiliation(s)
- Sibulelo Gawulayo
- Department of Social Work, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Charlene J Erasmus
- Centre for Interdisciplinary Studies on Children, Families and Society, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Anthea J Rhoda
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
7
|
Trenz RC, Seruya FM, Dondorf-Brooks K. Predictors of employment among underrepresented women and TANF recipients that completed vocational rehabilitation services. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rebecca C. Trenz
- Department of Psychology, School of Social & Behavioral Sciences, Mercy College, Dobbs Ferry, New York, USA
| | - Francine M. Seruya
- Department of Occupational Therapy, School of Health and Natural Sciences, Mercy College, Dobbs Ferry, New York, USA
| | - Kaitlin Dondorf-Brooks
- Department of Communication Sciences and Disorders, School of Health and Natural Sciences, Mercy College, Dobbs Ferry, New York, USA
| |
Collapse
|
8
|
Toglia J, Askin G, Gerber LM, Jaywant A, O'Dell MW. Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities. Front Neurol 2019; 10:1108. [PMID: 31681161 PMCID: PMC6813672 DOI: 10.3389/fneur.2019.01108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/03/2019] [Indexed: 01/16/2023] Open
Abstract
Purpose: To characterize and compare frequency and subjective dimensions of post-stroke participation in younger (<65) and older adults (>age 65), in social, productivity and leisure activities, 6 months post-inpatient rehabilitation. Secondary aims included exploration of demographic and clinical factors influencing desire for increased participation and comparison of two measures of participation. Methods: A prospective cohort study of people with stroke (n = 99) who were identified during their inpatient rehabilitation stay and followed-up 6 months post-discharge with telephone interviews using two self-report participation measures. The Stroke Impact Participation subscale (SIS-P) measured the frequency of perceived limitations in social, leisure, productive activities and extent of stroke recovery. The Community Participation Indicators (CPI) examined activity frequency, importance, and desire for increased activity engagement. Descriptive statistics were used to summarize demographic variables and characterize SIS-P and CPI items. Differences between age groups on individual items were examined. Associations between measures and demographic variables were explored. Results: Both groups reported a wide variation in participation restrictions that was not associated with stroke severity and weakly associated with discharge functional status (rho = 0.20-0.35). There were no significant differences between age groups in CPI frequency (for 18/19 items), or the SIS-P. However, there was a trend toward more participation restrictions on the SIS-P among those <65 (p = 0.07). Younger adults (n = 46; median age = 53) were significantly more likely to indicate that they were not doing selected activities enough on the CPI, compared with older adults (n = 56; median age = 76). While age and ethnicity were independently associated with some activities, it was not associated with other activities. The CPI and SIS-P were moderately related at a correlation of rho = 0.54, p < 0.001. Conclusion: The CPI demonstrated value and utility in examining subjective perspectives of activity importance and desire for change for people who are 6 months post-stroke. Although the CPI and SIS-P are moderately related, subjective appraisal of participation in selected individual activities (CPI) better distinguished between age groups and provided unique and distinct information from the SIS-P.
Collapse
Affiliation(s)
- Joan Toglia
- Mercy College, Dobbs Ferry, NY, United States.,Rehabilitation Medicine Department, Weill Cornell Medicine, New York, NY, United States
| | - Gulce Askin
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, United States
| | - Linda M Gerber
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, United States
| | - Abhishek Jaywant
- Rehabilitation Medicine Department, Weill Cornell Medicine, New York, NY, United States.,NewYork-Presbyterian Hospital, New York, NY, United States.,Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | - Michael W O'Dell
- Rehabilitation Medicine Department, Weill Cornell Medicine, New York, NY, United States
| |
Collapse
|