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Liao ZY, Haycock-Stuart E, Kean S. Biographical continuation: recovery of stroke survivors and their family caregivers in Taiwan. Prim Health Care Res Dev 2024; 25:e2. [PMID: 38179717 PMCID: PMC10790715 DOI: 10.1017/s1463423623000610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 07/28/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024] Open
Abstract
AIM To explore the experiences pertaining to long-term care services from the perspectives of dyads of stroke survivors and their family caregivers in indigenous and non-indigenous communities. BACKGROUND Stroke occurrence is a life-changing event associated with quality of life for stroke survivors and their families, especially those who provide primary support. Indigenous people are more likely to experience a stroke at a younger age and have a higher likelihood of hospitalisation and death due to health disparities. Few studies have investigated family dyads or indigenous populations to understand their experiences of coping with changed body-self and to contextualise their reintegration into communities post-stroke. METHODS Ethnographic fieldwork over nine months in 2018-2019 with indigenous, urban-based, and non-indigenous populations, resulting in 48 observations and 24 interviews with 12 dyads in three geo-administrative communities. FINDINGS The post-stroke recovery trajectory is illuminated, delineating the dyads' life transitions from biographical disruption to biographical continuation. The trajectory is shaped by seven states involving four mindsets and three status passages. The four mindsets are sense of loss and worry, sense of interdependence, sense of independence, and wellbeing state. The status passages identified in this study are acceptance, alteration, and identification. A community-based and family-centred long-term care system, aligning with medical healthcare and community resources, underpinned each dyad's biographical continuation by: (1) providing rehabilitation that afforded time and space for recovery adaptation; (2) acknowledging the individuality of family caregivers and helping to alleviate their multitasking; and (3) reintegrating stroke survivors into their communities. Key to determining the quality of recovery for the indigenous participants was their reintegration into their native community and regaining of identity. Therefore, integrating post-stroke care into various care contexts and incorporating indigenous-specific needs into policymaking can support dyads in adapting to their communities.
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Affiliation(s)
- Zih-Yong Liao
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin63247, Taiwan
| | - Elaine Haycock-Stuart
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, EdinburghEH8 9AG, UK
| | - Susanne Kean
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, EdinburghEH8 9AG, UK
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Balabanski AH, Dos Santos A, Woods JA, Thrift AG, Kleinig TJ, Suchy-Dicey A, Siri SR, Boden-Albala B, Krishnamurthi R, Feigin VL, Buchwald D, Ranta A, Mienna CS, Zavaleta C, Churilov L, Burchill L, Zion D, Longstreth WT, Tirschwell DL, Anand S, Parsons MW, Brown A, Warne DK, Harwood M, Katzenellenbogen JM. The Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review Protocol. Front Neurol 2021; 12:661570. [PMID: 33967945 PMCID: PMC8100239 DOI: 10.3389/fneur.2021.661570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Despite known Indigenous health and socioeconomic disadvantage in countries with a Very High Human Development Index, data on the incidence of stroke in these populations are sparse. With oversight from an Indigenous Advisory Board, we will undertake a systematic review of the incidence of stroke in Indigenous populations of developed countries or regions, with comparisons between Indigenous and non-Indigenous populations of the same region, though not between different Indigenous populations. Methods: Using PubMed, OVID-EMBASE, and Global Health databases, we will examine population-based incidence studies of stroke in Indigenous adult populations of developed countries published 1990-current, without language restriction. Non-peer-reviewed sources, studies including <10 Indigenous People, or with insufficient data to determine incidence, will be excluded. Two reviewers will independently validate the search strategies, screen titles and abstracts, and record reasons for rejection. Relevant articles will undergo full-text screening, with standard data extracted for all studies included. Quality assessment will include Sudlow and Warlow's criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and the CONSIDER checklist for Indigenous research. Results: Primary outcomes include crude, age-specific and/or age-standardized incidence of stroke. Secondary outcomes include overall stroke rates, incidence rate ratio and case-fatality. Results will be synthesized in figures and tables, describing data sources, populations, methodology, and findings. Within-population meta-analysis will be performed if, and where, methodologically sound and comparable studies allow this. Conclusion: We will undertake the first systematic review assessing disparities in stroke incidence in Indigenous populations of developed countries. Data outputs will be disseminated to relevant Indigenous stakeholders to inform public health and policy research.
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Affiliation(s)
- Anna H. Balabanski
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia,Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,*Correspondence: Anna H. Balabanski
| | - Angela Dos Santos
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - John A. Woods
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Amanda G. Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia
| | - Timothy J. Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Astrid Suchy-Dicey
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Susanna Ragnhild Siri
- Department of Community Medicine, Faculty of Health Sciences, Centre for Sami Health Research, UiT the Arctic University of Norway, Tromso, Norway
| | - Bernadette Boden-Albala
- Department of Population Health and Disease Prevention, Department of Epidemiology, University of California, Irvine, Irvine, CA, United States
| | - Rita Krishnamurthi
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L. Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Carol Zavaleta
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Leonid Churilov
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - Luke Burchill
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Deborah Zion
- Human Research Ethics Committee, Victoria University, Melbourne, VIC, Australia
| | - W. T. Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - David L. Tirschwell
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - Sonia Anand
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mark W. Parsons
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,University of New South Wales (UNSW) South Western Sydney Clinical School, Liverpool, NSW, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Donald K. Warne
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Matire Harwood
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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