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Klockar E, Kylén M, Gustavsson C, Finch T, Jones F, Elf M. Self-management from the perspective of people with stroke - An interview study. PATIENT EDUCATION AND COUNSELING 2023; 112:107740. [PMID: 37059027 DOI: 10.1016/j.pec.2023.107740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Self-management support can improve quality of life, mood, self-efficacy, and physical function following a stroke. Knowledge of how people with stroke understand and experience self-management in different contexts is crucial to developing effective self-management support. This study explored how people with stroke understand and practice self-management during the post-acute phase. METHOD A descriptive study using qualitative content analysis to explore data from semistructured interviews RESULTS: Eighteen participants were interviewed. Most participants interpreted self-management as 'taking care of their business' and 'being independent". However, they encountered difficulties performing daily activities, for which they felt unprepared. Although interest in implementing self-management support increases, participants did not report receiving specific advice from healthcare professionals. CONCLUSION People continue to feel unprepared to manage everyday activities after hospital discharge and must largely work things out for themselves. There is an overlooked opportunity to start the process of self-management support earlier in the stroke pathway, with healthcare professionals and people with stroke combining their skills, ideas and expertise. This would enable confidence to self-management to flourish rather than decrease during the transition from hospital to home. PRACTICAL IMPLICATIONS Individual tailored self-management support could help people with stroke more successfully manage their daily lives post-stroke.
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Affiliation(s)
- Erika Klockar
- School of Health and Welfare, Dalarna University, Falun, Sweden.
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden; Department of Health Sciences, Lund University, Lund, Sweden
| | - Catharina Gustavsson
- School of Health and Welfare, Dalarna University, Falun, Sweden; Center for Clinical Research Dalarna - Uppsala University, Falun, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Fiona Jones
- Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, London, UK
| | - Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
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2
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Venketasubramanian N, Yudiarto FL, Tugasworo D. Stroke Burden and Stroke Services in Indonesia. Cerebrovasc Dis Extra 2022; 12:53-57. [PMID: 35313314 PMCID: PMC9149342 DOI: 10.1159/000524161] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/13/2022] [Indexed: 11/19/2022] Open
Abstract
Stroke is a major cause of death and disability in Indonesia. Stroke requires high quality, fast and precise management to prevent and avoid disability and death. Stroke can be prevented by adequately controlling for risk factors and encouraging healthy life styles. Efforts are needed to organize health promotion programs at the community level. More and a better distribution of neurologists and neurointerventionalists is needed. All hospitals should have a CT scan machine and stroke units. Telemedicine for stroke patient is very promising endeavor for an integrated acute stroke management system.
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Affiliation(s)
| | | | - Dodik Tugasworo
- Department of Neurology, Dr. Kariadi Hospital/Faculty of Medicine Diponegoro University, Semarang, Indonesia
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3
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Ferdiana A, Post MWM, Bültmann U, van der Klink JJL. Barriers and facilitators for work and social participation among individuals with spinal cord injury in Indonesia. Spinal Cord 2021; 59:1079-1087. [PMID: 33828246 DOI: 10.1038/s41393-021-00624-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study using in-depth interviews. OBJECTIVES To describe experienced barriers and facilitators for work and social participation among individuals with spinal cord injury (SCI). SETTING Vocational rehabilitation (VR) center in Yogyakarta Province, Indonesia. METHODS Semi-structured interviews were conducted with 12 participants (8 males, 4 females) aged 24-67 years. Five participants still underwent vocational rehabilitation, while seven participants lived in the community. Thematic analysis was used. RESULTS None of the participants who worked before the injury returned to her/his previous occupation, most participants became self-employed. The frequency of participation in social activities decreased substantially. Barriers for work and social participation included health conditions and environmental barriers, including inaccessibility, stigma and discrimination and limited institutional support and services. Identified facilitators for work and social participation were perceived importance of work and social participation, adaptations to disability condition, and social support. CONCLUSION Barriers to engage in work and social activities for individuals with SCI in Indonesia are combination of physical limitations, lack of accessibility, stigma, and institutional barriers. The capacity of social networks such as family in facilitating participation should be strengthened during the VR processes. VR should provide marketing skills and link self-employed clients with the market, in collaboration with the private sector and industries. Immediate policy and programmatic action is needed to enable these individuals to enhance sustainable work and social participation.
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Affiliation(s)
- Astri Ferdiana
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands. .,Department of Public Health, Faculty of Medicine, University of Mataram, Mataram, Indonesia.
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
| | - Jac J L van der Klink
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo, Tilburg, The Netherlands.,Optentia, North-West University, Vanderbijlpark, South Africa
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4
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Mahendra Kumar JL, Rashid M, Muazu Musa R, Mohd Razman MA, Sulaiman N, Jailani R, P.P. Abdul Majeed A. The classification of EEG-based winking signals: a transfer learning and random forest pipeline. PeerJ 2021; 9:e11182. [PMID: 33850667 PMCID: PMC8019310 DOI: 10.7717/peerj.11182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/08/2021] [Indexed: 11/20/2022] Open
Abstract
Brain Computer-Interface (BCI) technology plays a considerable role in the control of rehabilitation or peripheral devices for stroke patients. This is particularly due to their inability to control such devices from their inherent physical limitations after such an attack. More often than not, the control of such devices exploits electroencephalogram (EEG) signals. Nonetheless, it is worth noting that the extraction of the features and the classification of the signals is non-trivial for a successful BCI system. The use of Transfer Learning (TL) has been demonstrated to be a powerful tool in the extraction of essential features. However, the employment of such a method towards BCI applications, particularly in regard to EEG signals, are somewhat limited. The present study aims to evaluate the effectiveness of different TL models in extracting features for the classification of wink-based EEG signals. The extracted features are classified by means of fine-tuned Random Forest (RF) classifier. The raw EEG signals are transformed into a scalogram image via Continuous Wavelet Transform (CWT) before it was fed into the TL models, namely InceptionV3, Inception ResNetV2, Xception and MobileNet. The dataset was divided into training, validation, and test datasets, respectively, via a stratified ratio of 60:20:20. The hyperparameters of the RF models were optimised through the grid search approach, in which the five-fold cross-validation technique was adopted. The optimised RF classifier performance was compared with the conventional TL-based CNN classifier performance. It was demonstrated from the study that the best TL model identified is the Inception ResNetV2 along with an optimised RF pipeline, as it was able to yield a classification accuracy of 100% on both the training and validation dataset. Therefore, it could be established from the study that a comparable classification efficacy is attainable via the Inception ResNetV2 with an optimised RF pipeline. It is envisaged that the implementation of the proposed architecture to a BCI system would potentially facilitate post-stroke patients to lead a better life quality.
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Affiliation(s)
- Jothi Letchumy Mahendra Kumar
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing and Mechatronics Engineering Technology, Universiti Malaysia Pahang, Pekan, Pahang Darul Makmur, Malaysia
| | - Mamunur Rashid
- Faculty of Electrical and Electronics Engineering Technology, Universiti Malaysia Pahang, Pekan, Pahang, Malaysia
| | - Rabiu Muazu Musa
- Centre for Fundamental and Liberal Education, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Mohd Azraai Mohd Razman
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing and Mechatronics Engineering Technology, Universiti Malaysia Pahang, Pekan, Pahang Darul Makmur, Malaysia
| | - Norizam Sulaiman
- Faculty of Electrical and Electronics Engineering Technology, Universiti Malaysia Pahang, Pekan, Pahang, Malaysia
| | - Rozita Jailani
- Faculty of Electrical Engineering, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Anwar P.P. Abdul Majeed
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing and Mechatronics Engineering Technology, Universiti Malaysia Pahang, Pekan, Pahang Darul Makmur, Malaysia
- Centre for Software Development & Integrated Computing, Universiti Malaysia Pahang, Gambang, Malaysia
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5
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Jackson SM, Solomon SD, Barker RN. Recovering is about living my life, as it evolves: perspectives of stroke survivors in remote northwest Queensland. Disabil Rehabil 2021; 44:3843-3852. [PMID: 33625948 DOI: 10.1080/09638288.2021.1890242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Recovering from stroke in remote Australia has rarely been considered, even though rehabilitation services are generally scarce. The primary purpose of this study was to explore stroke recovery, from the perspective of stroke survivors in remote northwest Queensland (NWQ), to explicate the lens through which they view recovering. The secondary purpose was to explore the role of technology to support stroke survivors in remote locations along their recovery journey. METHODS A qualitative study was undertaken using elements of constructivist grounded theory for data collection and analysis. Semi-structured interviews were conducted with fifteen stroke survivors and two partners living, working or travelling in remote NWQ. RESULTS From the participants' perspective, recovering in a remote area after stroke is about living my life, as it evolves by endeavouring to recover my way and navigating my recovery in my world. Technology was only considered helpful when it supported participants to recover their way in their world. CONCLUSION Recovering from stroke from the perspective of stroke survivors in remote NWQ is about living their life, as they want it to be, and as it unfolds within their own context. Technology only has a place when it can support them to recover their way in their world. These findings reinforce the importance of health professionals listening, learning about, and enabling stroke survivors along their recovery journey, within their remote context and support network.Implications for RehabilitationRecovering from the perspective of stroke survivors is about living their life as it evolves.To support stroke survivors from remote areas, health professionals need to listen to and learn from each stroke survivor about what matters to them, what works for them, and about their world; including the challenges (e.g., switching between services) and enablers (e.g., community support) as the stroke survivor perceives them.Finding ways to utilise the strengths within and around them, may improve the recovery process for the stroke survivor in a remote area, ensuring they can access care that meets their needs in their world.Working together with stroke survivors, health professionals need to consider how technology could help them to live their life, while recovering their way and in their world.
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Affiliation(s)
- Sarah M Jackson
- College of Healthcare Sciences, James Cook University, Townsville, Australia.,Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - S D Solomon
- Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - R N Barker
- Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia.,College of Healthcare Sciences, James Cook University, Cairns, Australia
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6
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Thrisna Dewi NLP, Arifin MT, Ismail S. The Influence of Gayatri Mantra and Emotional Freedom Technique on Quality of Life of Post-Stroke Patients. J Multidiscip Healthc 2020; 13:909-916. [PMID: 32982267 PMCID: PMC7500173 DOI: 10.2147/jmdh.s266580] [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] [Received: 06/10/2020] [Accepted: 08/18/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The quality of life in stroke patients is vital for survival. Nowadays, studies that show a decrease in quality of life in post-stroke patients are increasing. Various non-pharmacological modalities were explored in the past to improve rehabilitation. However, the study about the effects of religious mantra and its combination with the modern technique was lacking. Therefore, this study aimed to analyse the effects of Gayatri Mantra and Emotional Freedom Technique (EFT) on quality of life (QOL) of post-stroke patients. METHODS A quasi-experimental with pretest and posttest with the control group design was conducted. Forty-six post-stroke subjects with reduced quality of life based on Stroke Specific Quality of Life were consecutively recruited and divided into controls and intervention groups. The intervention group received additional treatment with Gayatri Mantra and EFT. In contrast, the control group attends and adheres only to the standard hospital rehabilitation program. RESULTS All indicators and the overall score of QOL in the intervention group showed significant improvement after treatment (p<0.05) compared with no improvement in the control group. Overall, a higher QOL score was observed in the intervention group at the end of the study. Mann-Whitney test shows significant differences between the final QOL score in intervention and control groups (p<0.001). CONCLUSION Gayatri Mantra and EFT are significantly increasing the quality of life of post-stroke patients.
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Affiliation(s)
| | - Muhamad Thohar Arifin
- Department of Neurosurgery, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Suhartini Ismail
- Emergency and Critical Care Division, Department of Nursing, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
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7
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Yap KH, Warren N, Reidpath DD, Allotey P. Understanding Cognitive Impairment after Stroke: Stories from a Middle-Income Country. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Kalkonde Y, Deshmukh S, Gokhale C, Jacob M, Bang A. Stroke Happens Suddenly so It Cannot Be Prevented: A Qualitative Study to Understand Knowledge, Attitudes, and Practices about Stroke in Rural Gadchiroli, Maharashtra, India. J Neurosci Rural Pract 2020; 11:53-62. [PMID: 32140004 PMCID: PMC7055643 DOI: 10.1055/s-0039-1700601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background
Strokes have emerged as one of the leading causes of deaths in rural India but people often remain uninformed about it. This study sought to understand knowledge, attitudes, and healthcare-seeking practices about strokes in rural Gadchiroli, India.
Methods
A total of 12 focus group discussions were conducted with 34 female and 43 male participants from six villages. Responses were audio recorded, transcribed, coded, and analyzed using inductive method of qualitative data analysis.
Results
Respondents correctly recognized many symptoms of stroke and were aware of the sudden onset of symptoms. They were unaware of transient ischemic attacks. After stroke, healthcare was sought from private physicians, and physicians in the government run district hospital, or traditional herbal providers depending upon the accessibility, affordability, and perceived effectiveness of the therapy. Most of the respondents thought that stroke is a serious disease associated with disability as well as death and its occurrence in the community is increasing. However, only a few participants could correctly state how stroke occurs and its risk factors. Furthermore, many participants thought that stroke cannot be prevented as it occurs suddenly without any warning.
Conclusion
Rural people in Gadchiroli were aware of symptoms of stroke but awareness about the etiology and the risk factors was low. Suddenness of symptoms was perceived as a key barrier to taking any preventive action. Understanding such perceptions and addressing them can help improve counseling of patients by physicians and effectiveness of behavioral change communication to prevent stroke in rural areas.
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Affiliation(s)
- Yogeshwar Kalkonde
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | - Sona Deshmukh
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | - Charuta Gokhale
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | - Mini Jacob
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Centre, San Antonio, Texas, United States
| | - Abhay Bang
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
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9
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Factors which Influence Risk Taking and the Evolution of Social-Identity in Stroke Narratives: A Thematic Synthesis. Behav Sci (Basel) 2020; 10:bs10020046. [PMID: 32023968 PMCID: PMC7071490 DOI: 10.3390/bs10020046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background: The disruption of a stroke can impact an individual’s sense of social identity. A comprehensive review is required to understand the factors and processes that influence changes in social identity following a stroke. Aims: To undertake a review of literature to discover a process of social identity evolution for people with stroke and identify the factors which influence it. Methods: A meta-ethnographic approach to review was undertaken and a subtle realist viewpoint was assumed. Studies were included if they documented experiences and perceptions relating to stroke. Eight electronic databases were searched from January 2009 until January 2019. Quality assessment and synthesis techniques were applied. Findings: Out of the 18 papers included, a total of 251 (141/251, 56% male, 109/251, 43% female, 1/251, 0.4% undisclosed) individuals were included within the synthesis. The evolution of social-identity model was developed and identified with five key stages to represent a process that individuals with stroke can experience. Factors which influence the process were identified and direct implications for clinical practice are given. Conclusion: This review has highlighted the major themes within the evolution of social identity and management strategies for risk taking to achieve a desired future. Further research is required to consider how these findings may be tested in clinical practice.
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10
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Mairami FF, Warren N, Allotey PA, Mak JS, Reidpath DD. Documenting the impact of stroke in a middle-income country: a Malaysian case study. Disabil Rehabil 2018; 42:102-113. [PMID: 30183424 DOI: 10.1080/09638288.2018.1493544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC).Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality.Implications for rehabilitationThe impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries.Support from the family and reinforcement of religious coping were judged to successfully aid recovery.Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.
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Affiliation(s)
- Fatima Fanna Mairami
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Clayton Campus, Monash University, Melbourne, Australia
| | - Pascale A Allotey
- UN University International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
| | - Jun Shin Mak
- School of Social Sciences, Clayton Campus, Monash University, Melbourne, Australia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,South East Asia Community Observatory (SEACO), Monash University, Segamat, Johor, Malaysia
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11
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Schröders J, Wall S, Hakimi M, Dewi FST, Weinehall L, Nichter M, Nilsson M, Kusnanto H, Rahajeng E, Ng N. How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis. PLoS One 2017; 12:e0179186. [PMID: 28632767 PMCID: PMC5478110 DOI: 10.1371/journal.pone.0179186] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/07/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) have emerged as a huge global health problem in low- and middle-income countries. The magnitude of the rise of NCDs is particularly visible in Southeast Asia where limited resources have been used to address this rising epidemic, as in the case of Indonesia. Robust evidence to measure growing NCD-related burdens at national and local levels and to aid national discussion on social determinants of health and intra-country inequalities is needed. The aim of this review is (i) to illustrate the burden of risk factors, morbidity, disability, and mortality related to NCDs; (ii) to identify existing policy and community interventions, including disease prevention and management strategies; and (iii) to investigate how and why an inequitable distribution of this burden can be explained in terms of the social determinants of health. METHODS Our review followed the PRISMA guidelines for identifying, screening, and checking the eligibility and quality of relevant literature. We systematically searched electronic databases and gray literature for English- and Indonesian-language studies published between Jan 1, 2000 and October 1, 2015. We synthesized included studies in the form of a narrative synthesis and where possible meta-analyzed their data. RESULTS On the basis of deductive qualitative content analysis, 130 included citations were grouped into seven topic areas: risk factors; morbidity; disability; mortality; disease management; interventions and prevention; and social determinants of health. A quantitative synthesis meta-analyzed a subset of studies related to the risk factors smoking, obesity, and hypertension. CONCLUSIONS Our findings echo the urgent need to expand routine risk factor surveillance and outcome monitoring and to integrate these into one national health information system. There is a stringent necessity to reorient and enhance health system responses to offer effective, realistic, and affordable ways to prevent and control NCDs through cost-effective interventions and a more structured approach to the delivery of high-quality primary care and equitable prevention and treatment strategies. Research on social determinants of health and policy-relevant research need to be expanded and strengthened to the extent that a reduction of the total NCD burden and inequalities therein should be treated as related and mutually reinforcing priorities.
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Affiliation(s)
- Julia Schröders
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Stig Wall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mohammad Hakimi
- Centre for Reproductive Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lars Weinehall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, College of Social and Behavioral Sciences, The University of Arizona, Tucson, United States of America
| | - Maria Nilsson
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hari Kusnanto
- Department of Family Medicine, Community Medicine and Bioethics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ekowati Rahajeng
- Center for Public Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Republic of Indonesia
| | - Nawi Ng
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
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12
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Moorley CR, Cahill S, Corcoran NT. Life after Stroke: Coping mechanisms among African Caribbean Women. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:769-778. [PMID: 26094703 DOI: 10.1111/hsc.12256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
In the UK, stroke is the third most common cause of death for women and the incidence in African Caribbean women is higher than that in the general population. Stroke burden has major consequences for the physical, mental and social health of African Caribbean women. In order to adjust to life after stroke, individuals affected employ a range of strategies which may include personal, religious (church) or spiritual support (i.e. prayer), individual motivation or resignation to life with a disability. This study explored these areas through the coping mechanisms that African Caribbean women utilised post stroke in the context of stroke recovery and lifestyle modification efforts needed to promote healthy living post stroke. A qualitative approach using interpretative phenomenological analysis was adopted. Seven women were recruited into the study. Semi-structured, in-depth interviews were audio recorded and were transcribed verbatim. Data were analysed using a four-stage framework: familiarisation, sense making, developing themes, and data refinement and analysis. Three main themes on coping emerged: the need to follow medical rules to manage stroke, strength and determination, and the use of religion and faith to cope with life after stroke. These findings illustrate both a tension between religious beliefs and the medical approach to stroke and highlight the potential benefits that religion and the church can play in stroke recovery. Implications for practice include acknowledgement and inclusion of religion- and church-based health promotion in post-stroke recovery.
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Affiliation(s)
- Calvin R Moorley
- Adult Nursing, Faculty of Health and Social Care, London South Bank University, London, UK.
| | - Sharon Cahill
- School of Psychology, University of East London, London, UK
| | - Nova T Corcoran
- School of Life Sciences, University of South Wales, Cardiff, UK
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13
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Jane Shamrock H, Gray M, Cameron M, Oprescu F. Physical disabilities in Asia: A meta-synthesis of qualitative literature written in English. Br J Occup Ther 2016. [DOI: 10.1177/0308022616640802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Research shows that occupational therapists and occupational therapy students are increasingly taking up positions in cross-cultural contexts where occupational form, social values and understanding of occupation are different to Western norms. It may be difficult for the occupational therapist to identify the implication of cultural differences. Method This meta-synthesis investigated lived experience of physical disability in East and Southeast Asia with the aim of identifying local understandings of disability, using the technique of meta-ethnography as described by Noblit and Hare. Findings Fourteen articles met the selection criteria and six overarching themes were identified concerning disability in Asia: theme (1), the influence of disability on relationships within primary groups; theme (2), journeys in resilience vary among individuals; theme (3), managing poor health makes disability difficult; theme (4), education is important and difficult for people with disabilities to achieve; theme (5), financial hardship is closely linked to disability; and theme (6), values and beliefs are enmeshed in the experiences of living with disabilities. Conclusion There is a wide range of experiences of disability. Occupational therapy services and research may be more effective for people with disabilities in cross-cultural settings, when these factors are investigated and incorporated into practice.
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Affiliation(s)
- H Jane Shamrock
- Occupational therapist and PhD candidate, School of Health and Sport Science, University of the Sunshine Coast, Maroochydore, Australia
| | - Marion Gray
- Associate Dean of Research and adjunct professor, School of Health and Sport Science, University of the Sunshine Coast, Maroochydore, Australia
| | - Melainie Cameron
- Associate Professor, School of Health and Sport Science, University of the Sunshine Coast, Maroochydore, Australia
| | - Florin Oprescu
- Senior Lecturer, School of Health and Sport Science, University of the Sunshine Coast, Maroochydore, Australia
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The complexities of 'otherness': reflections on embodiment of a young White British woman engaged in cross-generation research involving older people in Indonesia. AGEING & SOCIETY 2015; 35:986-1010. [PMID: 25892832 PMCID: PMC4396439 DOI: 10.1017/s0144686x14001366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2014] [Indexed: 12/02/2022]
Abstract
If interviews are to be considered embodied experiences, than the potential influence of the embodied researcher must be explored. A focus on specific attributes such as age or ethnicity belies the complex and negotiated space that both researcher and participant inhabit simultaneously. Drawing on empirical research with stroke survivors in an ethnically mixed area of Indonesia, this paper highlights the importance of considering embodiment as a specific methodological concern. Three specific interactions are described and analysed, illustrating the active nature of the embodied researcher in narrative production and development. The intersectionality of embodied features is evident, alongside their fluctuating influence in time and place. These interactions draw attention to the need to consider the researcher within the interview process and the subsequent analysis and presentation of narrative findings. The paper concludes with a reinforcement of the importance of ongoing and meaningful reflexivity in research, a need to consider the researcher as the other participant, and specifically a call to engage with and present the dynamic nature of embodiment.
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15
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Norris M, Jones F, Kilbride C, Victor C. Exploring the experience of facilitating self-management with minority ethnic stroke survivors: a qualitative study of therapists' perceptions. Disabil Rehabil 2014; 36:2252-61. [PMID: 24670190 PMCID: PMC4364271 DOI: 10.3109/09638288.2014.904936] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 03/03/2014] [Accepted: 03/12/2014] [Indexed: 11/13/2022]
Abstract
PURPOSE The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. METHODS 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. RESULTS Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. CONCLUSIONS This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences.
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Affiliation(s)
- Meriel Norris
- Centre for Research in Rehabilitation, School of Health Sciences and Social Care, Brunel University, London, UK
| | - Fiona Jones
- Faculty of Health and Social Care Science, St George's University of London & Kingston University, London, UK
| | - Cherry Kilbride
- Centre for Research in Rehabilitation, School of Health Sciences and Social Care, Brunel University, London, UK
| | - Christina Victor
- Brunel Institute of Ageing Studies, School of Health Sciences and Social Care, Brunel University, London, UK
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Rousseau N, Steele J, May C, Exley C. 'Your whole life is lived through your teeth': biographical disruption and experiences of tooth loss and replacement. SOCIOLOGY OF HEALTH & ILLNESS 2014; 36:462-476. [PMID: 24720855 DOI: 10.1111/1467-9566.12080] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The experience and meaning of tooth loss and replacement has varied historically and culturally but has received relatively little attention from social scientists. Our study set out to understand these experiences in the context of the arrival of newer, dental implant treatments. Semi-structured qualitative interviews were carried out with 39 men and women who had experienced tooth loss and replacement. A thematic analysis was sensitised by previous sociological work on chronic illness, particularly Bury's notion of biographical disruption. We found that while for some individuals the loss of a tooth was relatively insignificant, for others it was devastating and disruptive. In seeking to understand this difference, the concept of biographical disruption was a helpful analytical tool. Our analysis identified two forms of disruption. The first related to the meanings of tooth loss (the neglected mouth) and denture wearing (a marker of old age). The second, embodied, disruption concerned the relationship between the self and mouth in those wearing dentures (the invaded, unreliable mouth) and could occur even where tooth loss and denture wearing had been biographically anticipated.
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Mahayana IT, Sari DCR, Chen CY, Juan CH, Muggleton NG. The potential of transcranial magnetic stimulation for population-based application: a region-based illustrated brief overview. Int J Neurosci 2014; 124:717-23. [DOI: 10.3109/00207454.2013.872641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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