Informal stroke rehabilitation: what do Thai caregivers perform?

A Discourse Study on Handover Communication Among Care Providers in a Residential Care Home for Persons with Intellectual Disabilities

Abundant research has focused on handovers among nurses and/or doctors in hospitals; far less is known about handovers among care providers in non-clinical contexts, such as care homes for the elderly or the disabled. Focusing on handovers in a residential care home for persons with intellectual disabilities (RCHID), this study argues that handover communication in non-clinical settings is equally important. Ineffective handovers can lead to the deterioration of the residents' health conditions, chaotic situations and even injuries to both care providers and care recipients. Staff in RCHIDs rely heavily on handover communication to obtain information about the residents' needs and to offer appropriate care services. Combining discourse analysis with interactional sociolinguistics, this study analyzes written and spoken discourses involved in handover communication among care providers in a typical RCHID in Hong Kong to investigate what and how communicative functions were achieved through the participants' language use. The data were collected by convenience sampling, including handwritten notes and handover recordings of twelve sessions. Then a group interview of seven care providers was conducted to obtain supplementary data. Findings suggest that handover communication includes informational and interpersonal functions. While information delivery is the main purpose, care providers also establish relationships with one another through small talk about care home residents. The results suggest potential drawbacks of the handovers, including illegible notes, inconsistent information collection, and low interactivity. This study proposes a model that elucidates the correlation between discourse, handover communication and healthcare services, and suggests strategies to enhance such communication.

Solidão na perspectiva do idoso

Resumo Introdução: A solidão é um sentimento penoso e angustiante, que conduz a um mal-estar em que a pessoa se sente só, ainda que rodeada de pessoas, por pensar que lhe falta suporte, sobretudo de natureza afetiva. É mais frequente na adolescência, porém também o é nos idosos. Objetivo: Conhecer a opinião dos idosos em relação aos sentimentos de solidão. Metodologia: Respeitando a confidencialidade, foram inquiridos 73 idosos de ambos os sexos, que vivem em lares ou no domicílio habitual, mas frequentam centros-dia / de convivência. A amostra foi por conveniência, aleatória, constituída por idosos que se encontravam em condições de responder e o desejaram fazer. Foi utilizado um pequeno questionário, devidamente testado, de perguntas de resposta mista. Resultados: Para 78,1% dos entrevistados, a pessoa significativa era um familiar que não o cônjuge (sobretudo filhas e netas); 79,4% referiram sentir algumas vezes ou raramente / nunca solidão. São os viúvos e os divorciados que em maior percentagem referiam sentir muitas vezes solidão. Para diminuição da solidão, sugeriram diversas formas de convívio e atividades em que predominasse a comunicação. A solidariedade intergeracional foi também citada. Conclusões: Embora a solidão esteja descrita como um problema crescente nos idosos, nas pessoas que inquirimos sua frequência não era elevada, talvez pelo fato de os idosos entrevistados manterem atividades sociais. Seria importante realizar estudo longitudinal dirigido a idosos que permanecem no seu domicílio, com uma amostra representativa da população idosa em determinada região, praticando ou não atividades sociais, para abranger uma opinião mais alargada de idosos acerca da solidão.

Burden of care for persons with disabilities in Vietnam

Vietnam has more than 6 million persons with disabilities (PWD), or 7.8% of the population. To provide better services for them, it is important to investigate the care they currently receive, and to obtain evidence on the health outcomes from that care. This study aimed to estimate the quality of life and functional status of a group of PWD in Vietnam and the cost of care they receive. This was an analytical study exploring the time and cost of informal care, the cost of illness (prevalence-based, patient perspective), quality of life using EuroQoL and functional status using the Barthel Index. The sample was selected from urban and rural areas of Quang Tri province in Central Vietnam, using systematic random sampling. Data were collected by face-to-face interviews, and in a 1-month diary recorded during July-August 2010 for summer and in December 2010 for winter. The costs are presented in 2010 USD values. The data were analysed by descriptive, univariate and multivariate statistics to summarise and explore the relationships among dependent and independent variables. The study sample included 210 PWD, with an average age of 38 years and duration of disability on average 26 years. The health-related quality of life measured in terms of the health utility score (0 = death, 1 = full health) was on average 0.44 and 0.39 in summer and winter respectively. The total cost of illness per year per case was USD 971 (83% of gross domestic product per capita); explanatory variables were the age of the PWD, receiving community-based rehabilitation, receiving government support and the severity of the disability. This illustrates the importance of services and support for reduction of the economic burden on the family. In conclusion, the results of this study provide information on the burden caused by disabilities in rural and urban households in Vietnam.

Life interrupted and life regained? Coping with stroke at a young age

Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients’ life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an “altered sense of self,” a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by seeking external support, by restoring normality, and/or through positive reflection. Despite the adapted self that emerged, most individuals continued to experience impairments. While young stroke survivors adapt to their illness over time, they continue to experience impairments and disruptions in their personal and work lives. A holistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children.