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Singh H, Fakembe SP, Brown RK, Cameron JI, Nelson MLA, Kokorelias KM, Nekolaichuk E, Salbach NM, Munce S, Tang T, Gray CS, Haghayegh AT, Colquhoun H. Stroke Experiences and Unmet Needs of Individuals of African Descent Living in High-Income Economy Countries: a Qualitative Meta-Synthesis. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01725-z. [PMID: 37523144 DOI: 10.1007/s40615-023-01725-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Stroke service disparities experienced by individuals of African descent highlight the need to optimize services. While qualitative studies have explored participants' unique experiences and service needs, a comprehensive synthesis is lacking. To address current knowledge gaps, this review aimed to synthesize existing literature on the experiences of individuals of African descent impacted by a stroke living in high-income economy countries in terms of stroke prevention, management, and care. METHODS A qualitative meta-synthesis incorporating a meta-study approach was conducted to obtain comprehensive and interpretive insights on the study topic. Four databases were searched to identify qualitative English-language studies published in the year 2022 or earlier on the experiences of adults of African descent who were at risk or impacted by a stroke and living in high-income economy countries. Study methods, theory, and data were analyzed using descriptive and interpretive analyses. RESULTS Thirty-seven studies met our inclusion criteria, including 29 journal articles and 8 dissertations. Multiple authors reported recruitment as a key challenge in study conduct. Multiple existing theories and frameworks of health behaviours, beliefs, self-efficacy, race, and family structure informed research positionality, questions, and analysis across studies. Participant experiences were categorized as (1) engagement in stroke prevention activities and responses to stroke symptoms, (2) self-management and self-identity after stroke, and (3) stroke care experiences. CONCLUSIONS This study synthesizes the experiences and needs of individuals of African descent impacted by stroke. Findings can help tailor stroke interventions across the stroke care continuum, as they suggest the need for intersectional and culturally humble care approaches.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Semtetam Patience Fakembe
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Racquel K Brown
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle L A Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kristina M Kokorelias
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Geriatrics Division, Sinai Health System, University Health Network, Toronto, ON, Canada
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto Libraries, University of Toronto, Toronto, ON, Canada
| | - Nancy M Salbach
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sarah Munce
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Carolyn Steele Gray
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Arta Taghavi Haghayegh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Robinson A, Coxon K, McRae J, Calestani M. Family carers' experiences of dysphagia after a stroke: An exploratory study of spouses living in a large metropolitan city. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:924-936. [PMID: 35438234 DOI: 10.1111/1460-6984.12724] [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: 09/07/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND People with post-stroke dysphagia often require informal care from family to facilitate safe swallowing, modify food/drink or administer tube-feeds. Previous survey studies have found dysphagia may increase family caregiver burden. However, the experiences of family members in this population have not been fully explored. AIMS To explore family members' experiences of living with a spouse with post-stroke dysphagia. METHODS & PROCEDURES This exploratory qualitative study used one-to-one semi-structured interviews to explore family members' experiences. They were asked open questions about previous eating routines, dysphagia onset, their role and future hopes. Interviews were audio-recorded, transcribed and analysed thematically with an inductive approach to determine key features of family members' experiences. OUTCOMES & RESULTS Five spouses aged 70-93 years participated. Their relatives' strokes happened 3 months to 3 years before the interview. Five themes were identified: 'I do all of it'; making sense of dysphagia; emotional responses; reflecting on relationships; and redefining lifestyle. CONCLUSIONS & IMPLICATIONS It is important to consider family members' perspectives as they often provide vital care to loved-ones with dysphagia. In relation to eating and drinking, maintaining elements of previous routines seems important to families. Healthcare professionals should consider these when making recommendations for rehabilitation. Family members have differing perspectives of the comparative impact of dysphagia; patient and family priorities should be explored for healthcare professionals to provide better-targeted support. WHAT THIS PAPER ADDS What is already known on the subject Informal caregivers, often spouses, play a vital role in supporting the health and well-being of older people with health conditions. The presence of post-stroke dysphagia may present increased challenges for the informal caregiver. There are limited studies qualitatively exploring the experiences of informal caregivers in this population. What this paper adds to existing knowledge Current health and social care provision for this population leaves informal caregivers feeling they have been left to manage dysphagia alone. Informal caregivers demonstrate a breadth of knowledge about their spouse's dysphagia, problem-solving effective solutions. Informal caregivers have a range of interpretations of the nature and cause of dysphagia; leading to miscommunication with health professionals and complex emotional responses. What are the potential or actual clinical implications of this work? Healthcare professionals might consider ways in which to support dysphagic patients' families later in their care pathway, through scheduling reviews or running dysphagia patient and family groups. Health and social care professionals and policymakers should learn from informal caregivers' expertise to promote better health and quality-of-life outcomes for the patient and caregiver. Equal, open conversations between health and social care professionals and patients/families on their understanding of dysphagia may help informal caregivers to better voice their concerns and support mutual understanding. This has implications for adherence to recommendations, psychological well-being and patient safety.
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Affiliation(s)
- Anna Robinson
- School of Education, Midwifery and Social Care, Kingston and St George's, University of London, London, UK
| | - Kirstie Coxon
- School of Education, Midwifery and Social Care, Kingston and St George's, University of London, London, UK
| | - Jackie McRae
- Centre for Allied Health Education, Kingston and St George's, University of London, London, UK
| | - Melania Calestani
- School of Education, Midwifery and Social Care, Kingston and St George's, University of London, London, UK
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Naoum S, Konstantinidis TI, Spinthouri M, Mitseas P, Sarafis P. Patient Satisfaction and Physician Empathy at a Hellenic Air Force Health Service. Mil Med 2021; 186:1029-1036. [PMID: 33608724 DOI: 10.1093/milmed/usab060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/10/2020] [Accepted: 02/04/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patient satisfaction and physician empathy are important indicators of health care services quality. The purpose of this study is to investigate the factors related to the health care users' perception about physician empathy and their satisfaction with the services offered by the Medical Department of a Hellenic Air Force Combat Wing Health Service. MATERIALS AND METHODS One hundred and twenty six individuals who randomly visited the Medical Department from January to February 2019 participated in the survey. The "Measuring the satisfaction of visitors to hospital outpatient clinics" questionnaire by Aletras et al. and the Greek version of the "Jefferson Scale of Patient Perceptions of Physician Empathy" questionnaire were used for data collection. RESULTS High satisfaction scores were found in relation to the medical staff (mean 20.45, max 25), the examination room (mean 18.23, max 25), the nursing staff/secretarial support (mean 16.93, max 25), and the overall satisfaction (mean 17.15, max 25). The satisfaction score related to the infirmary was low (mean score 8.8, max 25). Physician empathy score was extremely high (mean 21.2, max 25). Statistically significant correlations were detected between physician empathy satisfaction score and the medical staff, nursing staff/secretarial support, and the overall satisfaction scores (P < .001). CONCLUSION Health care users reported high physician empathy and overall satisfaction scores but low infirmary satisfaction scores. The more positively that patients evaluated physician empathy, the more satisfaction that patients had with other measures.
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Affiliation(s)
- Symeon Naoum
- 251 Air Force General Hospital, Orthopedic Department, Athens, Attiki 115 25, Greece
| | | | - Maria Spinthouri
- Department of Nursing, Venizeleio Pananeio General Hospital of Heraklion, Heraklion, Crete 714 09, Greece
| | - Panagiotis Mitseas
- Department of Social Sciences, Hellenic Open University, Achaia, Patras 263 35, Greece
| | - Pavlos Sarafis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3036, Cyprus
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