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Jammal M, Kolt GS, Liu KPY, Guagliano JM, Dennaoui N, George ES. A systematic review and meta-analysis of randomized controlled trials to reduce burden, stress, and strain in informal stroke caregivers. Clin Rehabil 2024:2692155241271047. [PMID: 39194341 DOI: 10.1177/02692155241271047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
OBJECTIVES To understand the nature and effectiveness of interventions aimed at improving informal stroke caregiver burden, stress, and strain. DATA SOURCES In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of CENTRAL, CINAHL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted in May 2022. REVIEW METHODS Studies were eligible if they included an intervention designed for informal stroke caregivers, reported on caregiver burden, strain, or stress, were published in English, and used a randomized controlled trial design. An updated search was conducted in June 2024. The methodological quality of studies was appraised using the Cochrane risk-of-bias tool for randomized trials. The data were pooled, and a meta-analysis was completed for caregiver burden and strain outcomes. RESULTS Nineteen studies met inclusion criteria and were meta-analyzed. Interventions ranged from 4 days to 12 months. Most studies incorporated educational and/or support components. Meta-analyses revealed nonsignificant effects on caregiver burden or strain. Significant between-group differences for caregiver strain and burden were, however, found in seven studies. CONCLUSION Limited studies, small sample sizes, and conflicting results made definitive conclusions on the most effective intervention characteristics for improving caregiver outcomes difficult. Of the 19 studies, seven found significant between-group differences for caregiver outcomes postintervention, and these tended to incorporate educational components and comprised between seven and nine sessions. Further high-quality research is required to identify optimal format, duration, and frequency for improving caregiver outcomes.
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Affiliation(s)
- Melissa Jammal
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Karen P Y Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Justin M Guagliano
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Nariman Dennaoui
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Emma S George
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
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Mi Y, Qu S, Huang J, Yin Y, Luo S, Li W, Wang X. Effective evaluations of community nursing on rehabilitation for stroke survivors: A meta-analysis. Geriatr Nurs 2024; 57:80-90. [PMID: 38598907 DOI: 10.1016/j.gerinurse.2024.03.004] [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: 12/13/2023] [Revised: 02/20/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Long-term rehabilitation of stroke survivors is often difficult and new tools to improve quality of life should be proposed. Community nursing can be a cost-effective tool to positively impact the lives of stroke survivors. This meta-analysis aimed to comprehensively evaluate the effects of community nursing on rehabilitation for stroke survivors. METHODS The Cochrane Library, PubMed, Web of Science, CINAHL Plus, Embase, PEDro, China Knowledge Resource Integrated Database (CNKI), WANFANG, and WEIPU databases were comprehensively searched from their inception to April 18, 2023. The revised Cochrane risk-of-bias tool for RCTs(RoB 2 tool) was used to assess the quality of the included studies. Meta-analysis was conducted using the Stata 12.0 software package and Review Manager v5.3 software. RESULTS A total of 25 randomized controlled trials with 2537 participants were included in the meta-analysis. Compared with the control group, community nursing combined with routine nursing had a significantly superior effect on the Barthel Index(BI), Fugl-Meyer(FMA), National Institutes of Health Stroke Scale(NIHSS), Self-rating Anxiety Scale(SAS), and Self-rating Depression Scale(SDS) scores for stroke survivors (BI: MD: 18.48, 95 % CI [16.87, 20.08], P < 0.00001; FMA: MD: 12.61, 95 % CI [10.44, 14.78], P < 0.00001; NIHSS: MD: -2.94, 95 % CI [-3.50, -2.37], P < 0.00001; SAS: MD: -8.19; 95 % CI: [-9.46, -6.92], P < 0.00001; SDS: MD: -6.46 95 % CI [-7.23, -5.70], P < 0.00001). Subgroup analysis demonstrated that routine nursing, health education, exercise rehabilitation nursing and psychological nursing combined with different community nursing measures were significant in rehabilitation for stroke survivors and there was no heterogeneous in the studies of each subgroup(P > 0.1, I2 < 50 %). CONCLUSION This meta-analysis demonstrated that community nursing combined with routine nursing might improve activities of daily living, motor function and nerve function, and relieve anxiety and depression in stroke survivors. Overall, community nursing had a significant effect on rehabilitation of stroke survivors. However, this study still has limitations such as the overestimation effects caused by the sample size and the risk of bias caused by interventions. Future research will attempt to overcome these limitations and comprehensively assess the effect of community nursing on the rehabilitation of stroke survivors.
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Affiliation(s)
- Yuqing Mi
- School of Public Health, Shandong Second Medical University, Weifang 261053, China
| | - Siyang Qu
- School of Medicine, University College Cork, Cork T12YF78, Ireland
| | - Jingwen Huang
- School of Public Health, Shandong Second Medical University, Weifang 261053, China
| | - Yanling Yin
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao 266001, China
| | - Sheng Luo
- School of Management, Shandong Second Medical University, Weifang 261053, China
| | - Wei Li
- School of Public Health, Shandong Second Medical University, Weifang 261053, China.
| | - Xiang Wang
- School office, Shandong Second Medical University, Weifang 261053, China
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Canto DFD, Costa FMD, Woiciechoski LR, Cogo ALP, Paskulin LMG. Development of an online course for caregivers of older stroke patients. Rev Gaucha Enferm 2023; 44:e20230040. [PMID: 38055415 DOI: 10.1590/1983-1447.2023.20230040.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/17/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To describe the development process of a massive, open, and online course for family caregivers of older people who had a medically diagnosed stroke. METHOD Experience report on the development of a massive, open, and online course. The preparation of the course took place from July 2021 to October 2022 and consisted of the stages:definition and analysis of the contents of the course; construction and approval of the storyboard; digital construction and approval of the early version; making the project available on a digital platform; preliminary evaluation and approval of the final version. RESULTS The course aims to provide tools for the family care of older people who have suffered a stroke, improving their ability to provide care. It was built in twelve modules, using demonstrative videos, hypertext, pictures, and narrations. CONCLUSION The course development process required a team with expertise in different areas and had a positive preliminary assessment.
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Affiliation(s)
- Débora Francisco do Canto
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Francine Melo da Costa
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Lediane Raquel Woiciechoski
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Engenharia e Faculdade de Arquitetura. Programa de Pós-Graduação em Design. Porto Alegre, Rio Grande do Sul, Brasil
| | - Ana Luísa Petersen Cogo
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Lisiane Manganelli Girardi Paskulin
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem. Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
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Bierhals CCBK, Dal Pizzol FLF, Low G, Day CB, Santos NOD, Paskulin LMG. Calidad de vida en cuidadores de adultos mayores sobrevivientes de accidentes cerebrovasculares en el sur de Brasil: Ensayo clínico aleatorizado. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.5935.3656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumen Objetivo: evaluar el efecto de intervenciones de atención domiciliaria de enfermería sobre la calidad de vida en cuidadores familiares de adultos mayores sobrevivientes de accidentes cerebrovasculares. Método: Ensayo Clínico Aleatorizado, cegado para la evaluación de los desenlaces. Los participantes del estudio fueron 48cuidadores familiares de adultos mayores sobrevivientes de accidentes cerebrovasculares (ACV). El Grupo Intervención recibió tres visitas domiciliarias a cargo de enfermeros un mes después del alta hospitalaria, en las que se les ofreció instrucción relacionada con ACV (es decir, cómo acceder a los servicios de salud y realizar las actividades inherentes a los cuidados) y apoyo emocional. Al Grupo Control se le brindó la orientación habitual de los servicios de salud. La calidad de vida se evaluó mediante el instrumento World Health Organization Quality of Life Assessment (WHOQOL-BREF) y el módulo Old(WHOQOL-OLD) 1semana, 2meses y 1año después del alta. Resultados: en su mayoría, los cuidadores fueron mujeres, hijos o cónyuges. Los cuidadores de los grupos Intervención y Control no presentaron diferencias significativas en términos de su Calidad de Vida general de base. La intervención no ejerció ningún efecto entre la asignación a los grupos y la Calidad de Vida general(p=0,625) con el transcurso del tiempo. Sin embargo, la intervención sí tuvo efecto sobre las Relaciones Sociales (p=0,019) y la Autonomía(p=0,004). Conclusión: la intervención ejerció un efecto estadísticamente significativo sobre la calidad de vida de los cuidadores familiares con respecto a las relaciones sociales y a la autonomía. Registro del ensayo: NCT02807012.
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Affiliation(s)
| | | | | | - Carolina Baltar Day
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Grupo Hospitalar Conceição, Brazil
| | | | - Lisiane Manganelli Girardi Paskulin
- Universidade Federal do Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil
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Bierhals CCBK, Dal Pizzol FLF, Low G, Day CB, Santos NOD, Paskulin LMG. Qualidade de vida de cuidadores de idosos sobreviventes de AVC no sul do Brasil: Ensaio clínico randomizado. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.5935.3658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumo Objetivo: avaliar o efeito de intervenção educativa domiciliar de enfermagem na qualidade de vida de cuidadores familiares de idosos sobreviventes de acidente vascular cerebral (AVC). Método: Ensaio Clínico Randomizado, cego para avaliação de resultados. Quarenta e oito cuidadores familiares de idosos sobreviventes de AVC participaram do estudo. O Grupo de Intervenção recebeu três visitas domiciliares de enfermeiros, um mês após a alta hospitalar, para fornecer educação relacionada ao AVC (como acessar os serviços de saúde e realizar atividades de cuidado) e apoio emocional. O Grupo Controle recebeu as orientações habituais dos serviços de saúde. A qualidade de vida foi avaliada usando o instrumento Avaliação da Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-BREF) e o Módulo Old (WHOQOL-OLD) em 1 semana, 2 meses e 1 ano após a alta. Resultados: os cuidadores eram principalmente mulheres, filhos ou cônjuges. Os cuidadores do Grupo Intervenção e do Grupo Controle não diferiram significativamente em termos de Qualidade de Vida Geral no início do estudo. Não houve efeito de interação entre a alocação do grupo e a Qualidade de Vida Geral (p=0,625) ao longo do tempo. No entanto, houve efeito de interação para Relações Sociais (p=0,019) e Autonomia (p=0,004). Conclusão: a intervenção apresentou efeito estatisticamente significativo na qualidade de vida dos cuidadores familiares no que diz respeito às relações sociais e autonomia. Registro do ensaio clínico: NCT02807012.
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Affiliation(s)
| | | | | | - Carolina Baltar Day
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Grupo Hospitalar Conceição, Brazil
| | | | - Lisiane Manganelli Girardi Paskulin
- Universidade Federal do Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil
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Demir Avci Y, Gözüm S. Effects of Transitional Care Model-Based Interventions for Stroke Patients and Caregivers on Caregivers' Competence and Patient Outcomes: Randomized Controlled Trial. Comput Inform Nurs 2023; 41:805-814. [PMID: 36749850 DOI: 10.1097/cin.0000000000000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study evaluated the effectiveness of the Transitional Care Model Stroke Turkey for stroke patients and caregivers as regards the competence of caregivers and patient outcomes. It is a parallel-group, assessor-blinded monocenter conducted with 126 participants in total (66 intervention included 33 stroke patients and 33 caregivers; 60 control groups included 30 stroke patients and 30 caregivers), between March and August 2018. The Transitional Care Model Stroke Turkey program lasts for 13 to 20 weeks. It includes a 12-week follow-up after discharge, a minimum of three hospital visits, one home visit, minimum 18 phone calls, and Web-based training. The intervention group exhibited better caregiver competence (13.48 ± 2.31), preparation for care (28.48 ± 4.74), and e-health literacy (34.42 ± 4.74) than the control group (respectively, 11.37 ± 2.48, 20.93 ± 7.10, 26.93 ± 8.53) ( P < .001). Emotional exhaustion and depersonalization increased in the control group, but remained the same in the intervention group. Personal accomplishment decreased in the intervention group, unlike in the control group. Within 12 weeks of discharge, five patients from the intervention group and seven patients from the control group were rehospitalized. There was no statistical difference between stroke patients in either group in terms of having previously used home healthcare services. The Transitional Care Model Stroke Turkey is a practical model for stroke patients transitioning from hospital to home.
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Affiliation(s)
- Yasemin Demir Avci
- Author Affiliations: Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Oliveira-Kumakura ARDS, Batista LMOS, Spagnol GS, Valler L. Functionality and quality of life in Brazilian patients 6 months post-stroke. Front Neurol 2023; 14:1020587. [PMID: 37153670 PMCID: PMC10157197 DOI: 10.3389/fneur.2023.1020587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
Background Surviving a stroke poses a social and economic impact that requires the care system to be reformulated and the patient to be addressed in a comprehensive approach. Purpose This study aims to investigate if there is a relationship between functional activities performed before the stroke, patients' clinical and hospitalization data, and functionality and quality of life measures in the first 6 months after the stroke. Methods This study used a prospective cohort of 92 patients. We investigated sociodemographic and clinical data, the modified Rankin Scale (mRS), and the Frenchay Activities Index (FAI) during hospitalization. The Barthel Index (BI) and EuroQol-5D (EQ-5D) were applied at the following time points: 30 days (T1), 90 days (T2), and 180 days (T3) following postictal state. Statistical analysis was conducted using Spearman's coefficient, Friedman's non-parametric test, and multiple linear regression models. Results No correlation was found between FAI, BI, and EQ-5D average scores. Severe patients, patients with comorbidities, and patients with extended hospital stays showed lower BI and EQ-5D scores □in the follow-up. BI and EQ-5D scores increased. Conclusion This research found no relationship between activities performed before the stroke and functionalities and quality of life after the stroke, but comorbidities and extended hospital stay were associated with worse outcomes.
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Affiliation(s)
- Ana Railka de Souza Oliveira-Kumakura
- School of Nursing, University of Campinas, Campinas, Brazil
- Nursing Sciences Research Chair, Laboratory Education and Health Promotion, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Gabriela Salim Spagnol
- Nursing School, Anhanguera University, Sumaré, Brazil
- Knowledge Management and Education Solutions, Cogna Education, Valinhos, Brazil
| | - Lenise Valler
- Clinical Hospital, University of Campinas, Campinas, Brazil
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Bierhals CCBK, Dal Pizzol FLF, Low G, Day CB, dos Santos NO, Paskulin LMG. Quality of life in caregivers of aged stroke survivors in southern Brazil: Arandomized clinical trial. Rev Lat Am Enfermagem 2023; 31:e3657. [PMID: 36722630 PMCID: PMC9886075 DOI: 10.1590/1518-8345.5935.3657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/15/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE to evaluate the effect of nursing home care interventions on the quality of life in family caregivers of aged stroke survivors. METHOD a Randomized Clinical Trial, blinded for outcome evaluation. Forty-eighty family caregivers of aged stroke survivors participated in the study. The Intervention Group received three home visits by nurses one month after hospital discharge to provide stroke-related education (i.e., how to access health services and perform care activities) and emotional support. The Control Group received the usual guidance from the health services. Quality of life was assessed using the World Health Organization Quality of Life Assessment (WHOQOL-BREF) instrument and the Old Module(WHOQOL-OLD) 1 week, 2 months, and 1 year after discharge. RESULTS the caregivers were mainly women, children, or spouses. The caregivers in the Intervention Group and Control Group did not significantly differ in terms of their Overall Quality of Life at baseline. There was no interaction effect between group allocation and Overall Quality of Life(p=0.625) over time. However, there was an interaction effect for Social Relations(p=0.019) and Autonomy (p=0.004). CONCLUSION the intervention exerted a statistically significant effect on the quality of life of family caregivers with respect to social relationships and autonomy. TRIAL REGISTRATION NCT02807012.
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Affiliation(s)
| | | | - Gail Low
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada.
| | - Carolina Baltar Day
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Porto Alegre, RS, Brazil. , Grupo Hospitalar Conceição, Hospital Fêmina, Porto Alegre, RS, Brazil.
| | | | - Lisiane Manganelli Girardi Paskulin
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. , Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. , Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.
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Chou A, Lutz BJ, Beach SR, Freburger JK. Informal caregiver training to address functional mobility limitations of stroke survivors: a scoping review. Top Stroke Rehabil 2022:1-14. [PMID: 36403145 DOI: 10.1080/10749357.2022.2145761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Informal caregivers of stroke survivors often report the need for training on how to care for a loved one with functional mobility limitations. Evidence on training interventions to help informal caregivers with issues related to mobility is varied. The objective of this scoping review was to examine the literature including skill-based training interventions that educate caregivers on functional mobility for stroke survivors. RESEARCH DESIGN AND METHODS We extracted studies from OVID Medline, Cochrane, ISI Web of Knowledge, and Embase published between 1990 and 2021. At every stage of assessment, data extraction forms were used to reach consensus among at least three out of four authors. We followed PRISMA-ScR guidelines and Arskey and O'Malley's framework to chart information into several tables based on research questions and summarized with descriptive statistics. RESULTS Most studies were conducted outside the US focused on training in mobility and activities of daily living. The stroke survivor, on average, was an older individual (mean age 64.8 [SD = 5.3] years). The informal caregiver was predominately a younger female spouse (mean age 54.2 [SD = 6.3]). More than a third of the studies reported improvement in the stroke survivors' physical function post-intervention, with a mean follow-up time of 4.4 months. Effective studies tended to include stroke survivors with less cognitive and functional mobility limitations at higher training dosages. DISCUSSION AND IMPLICATIONS Gaps in our understanding of informal caregiver training for those caring for stroke survivors are identified, and recommendations are provided for future research.
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Affiliation(s)
- Aileen Chou
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Barbara J. Lutz
- School of Nursing, University of North Carolina-Wilmington, Wilmington, NC, USA
| | - Scott R. Beach
- University Center for Social and Urban Research, University of Pittsburgh, PA, USA
| | - Janet K. Freburger
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Elsheikh MA, Moriyama M, Rahman MM, Kako M, El-Monshed AH, Zoromba M, Zehry H, Khalil MH, El-Gilany AH, Amr M. Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial. BMJ Open 2022; 12:e049741. [PMID: 35168963 PMCID: PMC8852666 DOI: 10.1136/bmjopen-2021-049741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of a tailored multidimensional intervention in reducing the care burden of family caregivers of stroke survivors. This intervention considered caregivers' perceived needs and incorporated three evidence-based dimensions (psychoeducation, skill-building and peer support). DESIGN A prospective randomised control trial. SETTING A community-based study conducted in Egypt. PARTICIPANTS A total of 110 caregivers aged ≥18 years who cared for a survivor within 6 months of stroke, with modified Rankin Scale scores of 3-5, and without other physical disabilities or terminal illnesses were recruited between December 2019 and May 2020. Participants were assigned to the intervention group (IG; n=55) and control group (CG; n=55) through open-label, parallel 1:1 randomisation. INTERVENTION The IG was provided with tailored multidimensional interventions for 6 months until November 2020, including three home visits, six home-based telephone calls and one peer-support session. The CG received simple educational instructions at a single visit. OUTCOME The participants completed the Zarit Burden Interview (primary outcome) and the WHO Quality of Life-BREF (secondary outcome) before the intervention (T0), at 3 months (T1) and at 6 months (T2). RESULTS No differences were observed between the characteristics of the groups at baseline (T0). The independent t-test showed no significant differences in the care burden and Quality of Life (QoL) at T1 and T2 between the groups. The intervention had no significant effect on the outcomes between or within groups over time, as shown by the repeated-measures analysis of variance. However, the group and time interaction had significant main effects on caregivers' QoL (psychological and social domains). CONCLUSION The main results showed that participants in the IG did not experience an improvement in the main outcomes. Nevertheless, the improvement in the psychological and social domains may have been attributed to our intervention. TRIAL REGISTRATION NUMBER NCT04211662.
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Affiliation(s)
- Mahmoud Ahmed Elsheikh
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mayumi Kako
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ahmed Hashem El-Monshed
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Nursing Department, College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
| | - Mohamed Zoromba
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Hamada Zehry
- New Mansoura General Hospital, Neurology, Egypt Ministry of Health and Population, Mansoura, Egypt
| | - Maha Hazem Khalil
- Neurology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Mostafa Amr
- Psychiatry, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Kontou E, Thomas SA, Cobley C, Fisher R, Golding-Day MR, Walker MF. A Biopsychosocial Intervention for Stroke Carers (BISC): development and description of the intervention. Health Psychol Behav Med 2022; 10:92-103. [PMID: 34993008 PMCID: PMC8725872 DOI: 10.1080/21642850.2021.2016412] [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: 11/24/2022] Open
Abstract
Objective Family members of stroke survivors are often not supported for their caring role, with many reporting adjustment difficulties. This paper describes the development and content of a group-based intervention for informal carers of stroke survivors. Method The intervention is based on the theoretical foundation of the biopsychosocial model with the aim to understand and address the physical, psychological and social factors of caring for stroke survivors. Findings from a comprehensive literature review and a qualitative study with carers and stroke professionals were synthesized to guide the intervention development. The Template for Intervention Description and Replication (TIDieR) checklist was used as a framework to describe the intervention. Results The intervention integrates cognitive-behavioural approaches via the identification of the biopsychosocial (physical, emotional, social) factors that can have an impact on the well-being of carers. It includes education on stroke-specific topics and advice on coping strategies. It consists of six structured two-hour group sessions facilitated in a community setting. It provides information and support on adjusting to the caring role in the first year post-stroke. Intervention materials were designed for addressing carers’ specific needs using psychological techniques, such as problem-solving, goal setting and relaxation exercises. Conclusion We have underlined the importance for describing and reporting the process of intervention development for complex interventions in the context of stroke rehabilitation. An intervention addressing the needs of informal stroke carers (Biopsychosocial Intervention for Stroke Carers; BISC) has been developed and described. BISC was further evaluated in a single-centre feasibility randomized controlled trial.
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Affiliation(s)
- Eirini Kontou
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK.,Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Shirley A Thomas
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Christine Cobley
- Department of Clinical Psychology, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Rebecca Fisher
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Miriam R Golding-Day
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Marion F Walker
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
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Silva JKD, Boery RNSDO. Effectiveness of a support intervention for family caregivers and stroke survivors. Rev Lat Am Enfermagem 2021; 29:e3482. [PMID: 34495192 PMCID: PMC8432573 DOI: 10.1590/1518-8345.4991.3482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: to analyze the effectiveness of a support intervention on the burden and
stress of family caregivers and on the stroke survivors’ independence level,
compared to the Control Group. Method: a quasi-experimental study conducted with 37 participants (Intervention
Group, n=20; and Control Group, n=17). The intervention lasted 8 months. The
outcomes of the caregivers (burden and stress) and of the survivors
(independence level) were measured by the Zarit, Perceived Stress and Katz
scales, at the following moments: pre-intervention, the fourth month of the
intervention and post-intervention. The differences of these outcomes
between groups and intra-group and the effect size were calculated using the
Mann-Whitney and Friedman tests (Bonferroni adjustment by Wilcoxon) and the
Kendall’s W coefficient. Results: the Intervention Group reduced burden (p=0.039) and stress (p=0.009), mainly,
after 8 months of intervention, which was not observed in the Control Group.
The independence level did not change between the groups or moments
(p>0.05). The intervention presented moderate effect size (p=0.45 and
p=0.54). Conclusion: the intervention was effective to reduce the burden and stress of family
caregivers, but did not alter the stroke survivors’ independence level, when
compared to the Control Group.
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Affiliation(s)
- Jaine Kareny da Silva
- Universidade do Estado da Bahia, Departamento de Educação - Campus XII, Guanambi, BA, Brazil.,Scholarship holder at the Programa de Apoio à Capacitação Docente e de Técnicos Administrativos (Bolsa PAC-DT)/ Universidade do Estado da Bahia, Brazil
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Nikbakht-Nasrabadi A, Mardanian-Dehkordi L, Taleghani F. Abandonment at the Transition from Hospital to Home: Family Caregivers' Experiences. Ethiop J Health Sci 2021; 31:525-532. [PMID: 34483609 PMCID: PMC8365482 DOI: 10.4314/ejhs.v31i3.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background People with concurrent chronic conditions face different situations that lead to frequent transferring between the hospital and home. Despite the use of different strategies for improving transitional care, these transferring is associated with different challenges. This article aims to explore family caregivers' experiences of transitional care in diabetes with concurrent chronic conditions. Methods This descriptive explorative study was done at university hospitals in two big cities (Isfahan and Tehran) of Iran. The data collection was conducted from November 2018 to February 2020 using deep, semi-structured, and face-to-face interviews which are focused on family caregivers' experiences of transitional care. The researchers continued the sampling until the data saturation. Finally, 15 family caregivers were selected through purposive sampling. Data collection and data analysis were performed concurrently. Data were analyzed through the conventional content analysis method. Results Two main themes were identified: unsafe transition (unplanned discharge, inappropriate communication, lack of patient center care, and unavailable healthcare team) and erosive effort (financial burden, psychological stress, physical exhaustion, and lack of supportive sources). Conclusion The findings point to the importance of designing a discharge plan and preparing family caregivers before being discharged by healthcare providers. It appears to be essential for health managers and policymakers to pay attention to safe transitional care planning. The establishment of transitional care centers will help to ensure continuity of care. Future research focusing on the design and implementation of an appropriate transitional care model is recommended.
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Affiliation(s)
- Alireza Nikbakht-Nasrabadi
- Department of Medical Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Mardanian-Dehkordi
- Department of Medical Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Nursing and Midwifery Care Research Center, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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