1
|
Drummond H, Middleton TRF, Shepherd AI, Davenport S. Understanding the factors that influence stroke survivors to begin or resume exercise: a qualitative exploration. Top Stroke Rehabil 2024; 31:556-563. [PMID: 38288982 DOI: 10.1080/10749357.2024.2304970] [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: 08/29/2023] [Accepted: 12/30/2023] [Indexed: 07/25/2024]
Abstract
BACKGROUND Exercise after stroke has the potential to increase survivors' physical function and decrease disability. However, despite health professional reporting they recommend exercise to stroke survivors, the majority are physically inactive. Stroke survivors have previously expressed a lack of adequate knowledge and skills to engage in exercise. OBJECTIVES The aim of this study was to understand why active stroke survivors chose to (re)engage in exercise and how they went about doing so. A secondary aim was to understand if health professionals had a role in facilitating exercise engagement. METHODS Semi-structured interviews were conducted with stroke survivors who regularly engaged with exercise. Seven people aged between 60 and 71 years participated in the study. Time since stroke varied from 1 to 13 years. A reflexive thematic analysis approach was used to analyze interviews. RESULTS Exercise was spoken about in a positive light. For some, exercise had always been important, for others it became important after their stroke. The themes of Changing Support Over Time, Old and New Identity and Proactively Impacting the Future were developed. The participants felt that health professionals often facilitated engagement in exercise, although the type of support that was most valued differed at different points in the post-stroke journey. CONCLUSIONS Authoritative support from health professionals and family members helped participants to engage in exercise in the early stages after stroke. Collaboration and being part of a team was appreciated for ongoing exercise engagement. Exercise provided hope as participants developed their identity after stroke.
Collapse
Affiliation(s)
- Helena Drummond
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Thierry R F Middleton
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Anthony I Shepherd
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Sally Davenport
- Physiotherapy Group, Great Ormond Street Institute of Child Health, University College London, London, UK
| |
Collapse
|
2
|
Awamura K, Sakashita R. Development of a Situation-Specific Theory for the Transition of Survivors of Stroke With Dysphagia. ANS Adv Nurs Sci 2024:00012272-990000000-00092. [PMID: 38935386 DOI: 10.1097/ans.0000000000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
The process by which stroke survivors move toward health while facing various difficulties can be construed as a "transition." Importantly, nurses need to understand and support this state of transition effectively. This study developed a situation-specific theory to explain post-stroke transition by integrating the findings of a qualitative study that explored the rehabilitation experiences of stroke survivors with dysphagia with a scoping review of qualitative studies using the theoretical framework of transition theory. This theory will help understand the transitions that stroke survivors with dysphagia undergo during recovery and provide a framework for exploring nursing care to support healthy transitions.
Collapse
Affiliation(s)
- Kenji Awamura
- Author Affiliations: Graduate School of Nursing Art and Science, University of Hyogo, Akashi City, Hyogo, Japan (Mr Awamura); and College of Nursing Art and Science, University of Hyogo, Akashi City, Japan(Dr Sakashiata)
| | | |
Collapse
|
3
|
Pullano A, Melmed KR, Lord A, Olivera A, Frontera J, Brush B, Ishida K, Torres J, Zhang C, Dickstein L, Kahn E, Zhou T, Lewis A. Negative disease-related stigma 3-months after hemorrhagic stroke is related to functional outcome and female sex. J Stroke Cerebrovasc Dis 2024; 33:107830. [PMID: 38909872 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVES The objective of this study was to determine factors associated with negative disease-related stigma after hemorrhagic stroke. MATERIALS AND METHODS Patients with non-traumatic hemorrhage (ICH or SAH) admitted between January 2015 and February 2021 were assessed by telephone 3-months after discharge using the Quality of Life in Neurological Disorders (Neuro-QoL) Negative Disease-Related Stigma Short Form inventory. We evaluated the relationship between disease-related stigma (T-score >50) and pre-stroke demographics, admission data, and poor functional outcome (3-month mRS score 3-5 and Barthel Index <100). RESULTS We included 89 patients (56 ICH and 33 SAH). The median age was 63 (IQR 50-69), 43 % were female, and 67 % graduated college. Admission median GCS score was 15 (IQR 13-15) and APACHE II score was 12 (IQR 9-17). 31 % had disease-related stigma. On univariate analysis, disease-related stigma was associated with female sex, non-completion of college, GCS score, APACHE II score, and 3-month mRS score (all p < 0.05). On multivariate analysis, disease-related stigma was associated with female sex (OR = 3.72, 95 % CI = 1.23-11.25, p = 0.02) and 3-month Barthel Index <100 (OR = 3.46, 95 % CI = 1.13-10.64, p = 0.03) on one model, and female sex (OR = 3.75, 95 % CI = 1.21-11.58, p = 0.02) and 3-month mRS score 3-5 (OR = 4.23, 95 % CI = 1.21-14.75, p = 0.02) on a second model. CONCLUSION Functional outcome and female sex are associated with disease-related stigma 3-months after hemorrhagic stroke. Because stigma may negatively affect recovery, there is a need to understand the relationship between these factors to mitigate stroke-related stigma.
Collapse
Affiliation(s)
- Alyssa Pullano
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States
| | - Kara R Melmed
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Aaron Lord
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Anlys Olivera
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Psychiatry, New York, NY 10016, United States
| | - Jennifer Frontera
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Benjamin Brush
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Koto Ishida
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States
| | - Jose Torres
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States
| | - Cen Zhang
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States
| | - Leah Dickstein
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Ethan Kahn
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Ting Zhou
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States
| | - Ariane Lewis
- NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States.
| |
Collapse
|
4
|
Kitamura S, Miyamoto R, Watanabe S, Yoshida T, Ishii Y. Development of the Japanese version of the stroke stigma scale: a validity and reliability assessment. Top Stroke Rehabil 2024:1-10. [PMID: 38373013 DOI: 10.1080/10749357.2024.2318097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/04/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The stigma perceived by many post-stroke persons hinders their social lives. A scale to measure stigma is needed to identify social problems related to stigma, and to evaluate effectiveness of interventions. OBJECTIVES This study aimed to develop a Japanese version of the Stroke Stigma Scale (SSS-J), and confirm its utility by examining reliability and validity. METHODS Eighty community-dwelling post-stroke individuals were enrolled at six sites. After translating the scale into Japanese using back translation methods, psychometric properties of the rating scale, internal scale validity, and reliability were examined to fit the Rasch model. Criterion-related validity, construct validity, and test-retest reliability were examined using total scores transformed to logit. For test-retest reliability, 30 participants completed the SSS-J twice, one week apart. RESULTS Rasch analysis showed that the SSS-J had the best fit with 15 items on a 3-category rating scale. Item difficulty logits were -2.01 to 2.21, person ability logits were -4.69 to 0.62 (mean, -1.41), person reliability coefficient was 0.71 (separation index, 1.58), and item reliability coefficient was 0.96 (separation index, 5.04). For criterion validity, Spearman's rank correlation coefficient with the Center for Epidemiologic Studies Depression Scale was 0.51 (p < 0.001). For construct validity, Spearman's rank correlation coefficients with each subscale of the Stroke Impact Scale ranged from -0.36 to -0.16 (p = 0.002-0.126). For test-retest reliability, the intra-class correlation coefficient was 0.64 (p < 0.001). CONCLUSIONS The SSS-J adapted to the Rasch model was reliable and valid. This scale can be used to quantitatively measure stigma among community-dwelling post-stroke persons in Japan.
Collapse
Affiliation(s)
- Shin Kitamura
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Reiko Miyamoto
- Department of Occupational Therapy, School of Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Shota Watanabe
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Taiki Yoshida
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Yoshikazu Ishii
- Department of Occupational Therapy, Faculty of Rehabilitation, Gunma Paz University, Gunma, Japan
| |
Collapse
|
5
|
Murray CM, Weeks S, van Kessel G, Guerin M, Watkins E, Mackintosh S, Fryer C, Hillier S, Stanley M. Perspectives of choice and control in daily life for people following brain injury: A qualitative systematic review and meta‐synthesis. Health Expect 2022; 25:2709-2725. [DOI: 10.1111/hex.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Carolyn M. Murray
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Scott Weeks
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | | | - Michelle Guerin
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | | | - Shylie Mackintosh
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Caroline Fryer
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Susan Hillier
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Mandy Stanley
- School of Medical and Health Sciences Edith Cowan University Joondalup Western Australia Australia
| |
Collapse
|
6
|
Russell C, Kohe GZ, Evans S, Brooker D. Rethinking Spaces of Leisure: How People Living with Dementia Use the Opportunities Leisure Centres Provide to Promote their Identity and Place in the World. INTERNATIONAL JOURNAL OF THE SOCIOLOGY OF LEISURE 2022. [PMCID: PMC9610313 DOI: 10.1007/s41978-022-00121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report on research that found joining activities within community leisure and fitness centres (Centres) enabled people living with dementia to create meaning about everyday life and foster identity. Focusing on three Centres in England, the study was informed by the experiences and accounts of four people living with dementia, their life-partner (if applicable) and the sports professional most closely associated with the person as each participated within a range of leisure opportunities. The methodology was underpinned by phenomenological philosophy and utilised participative methods. Theoretically, the paper draws upon considerations of serious leisure that provide ways in which the participants’ experiences could be understood and wider implications considered. Conceptual themes we derived from the data analysis were place, citizenship, and belonging (where the Centre acting as a physical space was important); identity and interaction (where the focus was upon space making and embodiment); safe spaces and care (i.e., how wellbeing was sustained and how participation and meaningful engagement occurred within the space); and, the value of Centres as opportunity structures (where all of these themes coalesced). Amid current public health debates over resourcing and care, this research provides timely insights and continued needed debates on the relationship between adequate social, economic and political support/resourcing, and the ability of Centres to facilitate and sustain meaningful and safe spaces. Beyond, we suggest our findings offer learning that might extend to wider contexts; for example, through including Centres within social care and health initiatives, where emphasis will be upon participation as a citizen rather than as a patient.
Collapse
Affiliation(s)
- Christopher Russell
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
| | - Geoffery Z. Kohe
- School of Sport & Exercise Sciences, University of Kent, Chatham, UK
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
| |
Collapse
|
7
|
Currie S, Douglas J, Winkler D. 'What's next?' The journey from hospital to community engagement from the perspectives of adults following severe acquired brain injury: a scoping review protocol. BMJ Open 2022; 12:e064226. [PMID: 36130757 PMCID: PMC9494587 DOI: 10.1136/bmjopen-2022-064226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Community integration and social participation remain a challenge for many individuals following acquired brain injury (ABI) and the transition from hospital to home is a complex journey. It is important to conceptualise this transition from the perspective of people with ABI, to inform future research with the overall aim of improving the experience of community re-engagement and maintaining important relationships within social networks. METHODS AND ANALYSIS The methodology outlined by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: extension for Scoping Reviews will be used to guide the review. A comprehensive electronic database search will be conducted in MEDLINE, CINAHL, Scopus, Embase and PsychINFO. The search will aim to locate only published, qualitative or mixed methods studies and will be limited to citations published in English, from January 2014 to the date of final search completion. Quality assessment using the Critical Appraisal Skills Programme will be completed and reported.Data extraction will include participant and study characteristics.Finally, qualitative data from each citation, including participant quotes, will be extracted and thematic analysis will be completed to support conceptualisation of community participation from those who have experienced the transition to the community following discharge from hospital. Three individuals with lived experiences of ABI will be engaged as paid consultants to review and comment on the findings of the review. ETHICS AND DISSEMINATION It is intended that the findings from this review will be made available to relevant stakeholders through peer-reviewed publications and conference presentations. This scoping review does not require an ethics application.
Collapse
Affiliation(s)
- Suzanne Currie
- Living with Disability Research Centre, La Trobe University, Bundoora, Victoria, Australia
- Research Unit, Summer Foundation, Blackburn, Victoria, Australia
- Physiotherapy Department, Alfred Health, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Bundoora, Victoria, Australia
- Research Unit, Summer Foundation, Blackburn, Victoria, Australia
| | - Di Winkler
- Living with Disability Research Centre, La Trobe University, Bundoora, Victoria, Australia
- Research Unit, Summer Foundation, Blackburn, Victoria, Australia
| |
Collapse
|
8
|
Tu J, Xue X, Bai X, Liu Y, Jia M, Zhou H. Development of a self-help cognitive behavioral therapy programme for reducing the stigma of stroke survivors: a modified delphi study. Top Stroke Rehabil 2022; 30:468-482. [PMID: 35686678 DOI: 10.1080/10749357.2022.2083296] [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: 10/18/2022]
Abstract
BACKGROUND Stigma is a common psychological consequence for stroke survivors that aggravates their physical and psychological burden and hinders their rehabilitation. Currently, there are few interventions targeted at the stigma of stroke survivors. OBJECTIVES This study reports on the development of a self-help cognitive behavioral therapy (CBT) programme driven by a logical model of stigma in stroke survivors, CBT and the advice of multidomain experts. METHODS A logical model of stigma in stroke survivors was derived from a systematic search of the literature and semistructured interviews with 21 patients to identify factors influencing stigma. The item content of the programme was generated based on this logical model in combination with CBT. A modified Delphi process with an expert panel of multidomain experts was used to evaluate and refine the content of the programme. SPSS 20.0 was used for data analysis. RESULTS Seventeen experts accepted the invitation to participate, and all completed two rounds of the Delphi survey. Six sections and 26 items were identified. Consensus was reached among experts that the self-help CBT programme included the following six sections: health education, understanding stigma, cognition change, skills training and self-care, self-acceptance and relapse prevention. CONCLUSIONS The self-help CBT programme includes health education and psychological education. This study extends the limited body of research on stroke-related stigma interventions, and the next step is to evaluate its efficacy in trials.
Collapse
Affiliation(s)
- Jinyi Tu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Xue
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xuejie Bai
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue Liu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Miao Jia
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongzhen Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
9
|
Lamont RA, Calitri R, Mounce LTA, Hollands L, Dean SG, Code C, Sanders A, Tarrant M. Shared social identity and perceived social support among stroke groups during the COVID-19 pandemic: Relationship with psychosocial health. Appl Psychol Health Well Being 2022; 15:172-192. [PMID: 35139581 PMCID: PMC9111261 DOI: 10.1111/aphw.12348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
Community-based peer support groups for stroke survivors are common in the United Kingdom and aim to support rehabilitation. This study of 260 stroke survivors across 118 groups nationally used an online survey format, completed on average 3 months into the pandemic. Analysis of both quantitative and open-ended responses provided insights into how stroke group members maintained contact during the COVID-19 pandemic and how the group processes of shared social identity and perceived social support related to psychosocial outcomes (self-esteem, well-being and loneliness). Group members adapted to the pandemic early through telephone calls (61.6% of participants) and internet-based contact (>70% of participants), although also showed a desire for greater contact with their groups. A stronger sense of shared social identity and perceptions of social support from the stroke groups were weakly associated with reductions in loneliness among members, and greater perceived social support was associated with higher self-esteem. However, having poor health and living alone were more strongly associated with more negative psychosocial outcomes. The discussion considers how barriers to contact during pandemics can be managed, including access and use of online communication, limitations imposed by stroke-related disability, and how the experience of feeling supported and social identification can be better nurtured within remote contexts.
Collapse
Affiliation(s)
- Ruth A. Lamont
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Raff Calitri
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - Laura Hollands
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Sarah G. Dean
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Chris Code
- Department of PsychologyUniversity of ExeterExeterUK
| | - Amy Sanders
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Mark Tarrant
- College of Medicine and HealthUniversity of ExeterExeterUK
| |
Collapse
|
10
|
The experience of close personal relationships after stroke: scoping review and thematic analysis of qualitative literature. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background and Purpose:
Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.
Method:
Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.
Results:
While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.
Conclusions:
Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.
Collapse
|
11
|
van Dongen L, Hafsteinsdóttir TB, Parker E, Bjartmarz I, Hjaltadóttir I, Jónsdóttir H. Stroke survivors' experiences with rebuilding life in the community and exercising at home: A qualitative study. Nurs Open 2021; 8:2567-2577. [PMID: 33690972 PMCID: PMC8363348 DOI: 10.1002/nop2.788] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/04/2021] [Accepted: 01/31/2021] [Indexed: 01/27/2023] Open
Abstract
Aim This study aimed to explore how stroke survivors deal with stroke‐related impairments when rebuilding their lives in the community and their experiences of exercising at home. Design An explorative and descriptive qualitative study. Methods A purposive sample of ten stroke survivors residing at home was recruited to explore experiences of rebuilding their lives in the community and exercising at home. One focus group interview was conducted followed by semi‐structured interviews. Data were analysed using thematic analysis. Results Three main themes were identified: “Framing exercise within the context of everyday life” describes how stroke survivors integrate exercise in everyday activities with varying success and the social importance of exercising; “Managing the challenges of physical impairment” describes the taxing undertakings in daily living, loss of concentration and identity; “Long‐term challenges of everyday life” describes how the stroke survivors manage depression and live with a sense of uncertainty.
Collapse
Affiliation(s)
- Lisa van Dongen
- Julius Center for Health Sciences and Primary Care, Nursing Science Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thóra B Hafsteinsdóttir
- Julius Center for Health Sciences and Primary Care, Nursing Science Department, University Medical Center Utrecht, Utrecht, The Netherlands.,Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ethna Parker
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | | | - Ingibjörg Hjaltadóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland.,Landspítali University Hospital, Reykjavík, Iceland
| | - Helga Jónsdóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland.,Landspítali University Hospital, Reykjavík, Iceland
| |
Collapse
|
12
|
Hu R, Wang X, Liu Z, Hou J, Liu Y, Tu J, Jia M, Liu Y, Zhou H. Stigma, depression, and post-traumatic growth among Chinese stroke survivors: A longitudinal study examining patterns and correlations. Top Stroke Rehabil 2020; 29:16-29. [PMID: 33371827 DOI: 10.1080/10749357.2020.1864965] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: With the development of positive psychology, several studies show that positive and negative emotions are not always opposing. Understanding how positive and negative emotions correlate and the factors contributing to resilience in stroke survivors requires further research.Objectives: To identify the patterns and correlations of stigma, depression, and posttraumatic growth (PTG) among stroke survivors.Methods: Stroke-related stigma, depression, PTG, and neurological status were evaluated at 1-month and 3 months post-stroke using the Stroke Stigma Scale (SSS), Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Posttraumatic Growth Inventory (C-PTGI), modified Rankin Scale (mRS), and Social Support Rating Scale (SSRS). The paired t-test, nonparametric test, and Spearman's correlation test were used to analyze differences and relationships between results at the two time points.Results: At 3 months compared to 1-month post-stroke, we found significant reductions in mRS and stigma scores, and an increase in PTGI scores, while the PHQ-9 scores reduced non-significantly. SSS, PHQ-9, and mRS scores were positively correlated with each other at time1 (all P < .01), and all showed no significant relationships with PTGI scores (all P > .05). Social support scores were negatively correlated with stigma (P < .01), PHQ-9 (P < .01), and PTGI scores (P > .05) at 3 months.Conclusions: Stroke-related stigma is strongly associated with depression while neither of them has significant relationships with PTG during the early stage of survivors' rehabilitation in our study. Neurological impairment is a risk factor for negative emotions and increasing individualized support may reduce stigma, depression, and promote PTG in the long term.
Collapse
Affiliation(s)
- Ruidan Hu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoyan Wang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhihong Liu
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, China
| | - Jiakun Hou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yangyang Liu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinyi Tu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Miao Jia
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue Liu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongzhen Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
13
|
Gray LA. Living the Full Catastrophe: A Mindfulness-Based Program to Support Recovery from Stroke. Healthcare (Basel) 2020; 8:healthcare8040498. [PMID: 33228109 PMCID: PMC7711731 DOI: 10.3390/healthcare8040498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 12/30/2022] Open
Abstract
Decades of research suggest that Mindfulness-Based Stress Reduction (MBSR) training supports a greater capacity to live with chronic medical conditions and contributes to lowering stress levels. This paper introduces a model for a Mindfulness-Based Recovery from Stroke (MBRfS) for promoting stroke recovery, informed by the lived experience of the author (a stroke survivor and certified MBSR instructor), the research literature regarding MBSR training, and the specific challenges of stroke recovery. Four themes emerged from the autoethnographic analysis that informed the proposed model: Readiness to accept the stroke event and the acquired brain injury, navigating uncertainties of stroke recovery with awareness and self-responsibility for outcomes, trusting the inherent wisdom of the body as a stroke recovery "teacher", and increased capacity to integrate complex emotions with self-compassion, and a sense of wholeness. A four-component MBRfS model is offered, which consists of an integration amongst a modified MBSR framework, emergent attitudinal themes, and insights from the autoethnographic vignettes. The MBRfS model offers a path for providing participants with a supportive experience within stroke recovery. Recommendations and suggestions for future studies are offered to support the development of MBRfS for stroke survivors and their caregivers, as well as contributing to healthcare providers.
Collapse
Affiliation(s)
- Lori A Gray
- Holistic Health Programs, Western Michigan University, Kalamazoo, MI 49008, USA
| |
Collapse
|
14
|
Meads H, Hunt J, Page A, Withy L, Plowman R, Calder A. Stroke survivors’ experiences of upper limb recovery: a systematic review of qualitative studies. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Hayley Meads
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Jamie Hunt
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Alister Page
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Lee Withy
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Rose Plowman
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Allyson Calder
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| |
Collapse
|
15
|
Rasmus A, Orłowska E. Marriage and Post-stroke Aphasia: The Long-Time Effects of Group Therapy of Fluent and Non-fluent Aphasic Patients and Their Spouses. Front Psychol 2020; 11:1574. [PMID: 32733342 PMCID: PMC7358429 DOI: 10.3389/fpsyg.2020.01574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 06/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies of therapy influence on after-aphasia marital relations are lacking. Much needs to be learned about the range of factors associated with couples benefiting from therapy. Understanding these issues is key to facilitating optimal post-aphasia outcomes from the perspective of the patient and his caretaking spouse. This paper reports an evaluation of a group therapy intervention conducted with aphasic people and their life partners. METHODS The intervention comprised of 10 sessions of approximately 90 min duration and included two groups of couples, with fluent and non-fluent aphasic partner. The therapy program consisted of basic communication activities within the group which encouraged sharing of personal experience but mostly relied on psychoeducation, gaining knowledge about after-stroke aphasia. The respondents were interviewed and completed neuropsychological assessment. Quality of marriage was determined using Dyadic Adjustment Scale. Marital adjustment was measured twice, before intervention and after 6 months. Long-time effects of therapy included a significant mean difference in quality of marriage between therapy attendants and controls. Marital relationship decline seems to be worse amongst control subjects, who were not involved in any kind of psychological support. In spite of initial non-distressed relationship they report deterioration of their bond in half a year's time. We also showed changes in dynamics of quality of marriage during this time in all investigated groups. The implications of these findings for counseling services are discussed.
Collapse
Affiliation(s)
- Anna Rasmus
- Instytut Psychologii, Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Bydgoszcz, Poland
| | - Edyta Orłowska
- Instytut Psychologii, Uniwersytet Gdański, Gdańsk, Poland
| |
Collapse
|
16
|
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.
Collapse
|
17
|
Deng C, Lu Q, Yang L, Wu R, Liu Y, Li L, Chen S, Wei S, Wang Y, Huang Y, Fu L, Yue Z. Factors associated with stigma in community-dwelling stroke survivors in China: A cross-sectional study. J Neurol Sci 2019; 407:116459. [DOI: 10.1016/j.jns.2019.116459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 12/28/2022]
|
18
|
Jellema S, van Erp S, Nijhuis-van der Sanden MWG, van der Sande R, Steultjens EMJ. Activity resumption after acquired brain injury: the influence of the social network as described by social workers. Disabil Rehabil 2019; 43:1137-1144. [PMID: 31429344 DOI: 10.1080/09638288.2019.1652855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To understand how the social network of patients with acquired brain injury facilitates or hinders resumption of their activities, such as social and leisure activities, and how this affects patients' well-being and quality of life. METHODS Thematic analysis was applied to 70 narratives about family members, friends, neighbors and colleagues helping or hindering patients in resuming their activities. The narratives were derived from social workers with extensive experience with brain-injured patients and their social networks. RESULTS The narratives show that an available, understanding and well-informed network enhances activity resumption by being inclusive and encouraging patients to develop their skills. This is in line with earlier studies based on patients' experiences. Whereas the patient-based studies emphasize that being unsupportive or overprotective hinders patients from resuming their activities, this study also shows that preventing patients from meeting others or placing too-high demands results in activity loss, social isolation and reduced well-being and quality of life. CONCLUSIONS Several social network factors play a role in activity resumption, well-being, and quality of life of after brain injury. Early after the brain injury, rehabilitation professionals should work with patients' family members, friends, and others and educate them about how to provide adequate support.IMPLICATIONS FOR REHABILITATIONSince the patient's social network is an important determinant of activity resumption, rehabilitation professionals should analyze its features soon after brain injury, such as whether patients have an understanding network that encourages them and includes them in their activities.Since especially close network members tend to be protective of or place high demands on the patient, rehabilitation professionals should explain to them the importance of activity resumption for the patient's wellbeing and the adverse effects of being overprotective or over-demanding.Rehabilitation professionals should include other network members, such as friends or colleagues, in the rehabilitation process and educate them about how to support patients in resuming their activities.
Collapse
Affiliation(s)
- Sandra Jellema
- Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands.,Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Sabine van Erp
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands.,Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Rob van der Sande
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Esther M J Steultjens
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Martin-Saez MM, James N. The experience of occupational identity disruption post stroke: a systematic review and meta-ethnography. Disabil Rehabil 2019; 43:1044-1055. [PMID: 31373246 DOI: 10.1080/09638288.2019.1645889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE After a stroke, most individuals cannot participate in some of their valued occupations, disrupting their occupational identity. The aim of this interpretive synthesis is to systematically review the existing body of research to develop an understanding of the experience of occupational identity disruption post-stroke. METHODS A systematic review of the literature that included nine electronic databases, reference lists screening and grey literature checking was completed. Ten studies published between January 2012 and October 2018 were included. Meta-ethnography was used for the interpretive synthesis. FINDINGS A three-staged process model was created. Stage 1 illustrates the four factors involved in occupational identity disruption: "A fragmented and externalized body", "losing control, freedom and independence", "changed social and familial interactions", and "occupational participation loss". Stage two explains the experience of occupational identity disruption: "Occupational identity loss", "a de-valued self", and "threat to identity continuity". Stage three shows the individual's coping strategies: "protecting one's self", "social isolation", and "re-inventing one's occupational self". CONCLUSIONS Stroke impacts on an individual's occupational identity, compromising the continuity of a stroke survivor's sense of self. However, occupational identity is fluid; this can be used to support individuals to re-invent the occupational self. A conceptual model was developed to support the application of these results in clinical practice.Implications for rehabilitationOccupational identity disruption impacts on stroke survivors' self-value and sense of self continuity.Health care professionals' understanding of stroke survivors experience of occupational identity disruption could contribute to realign stroke survivors and clinicians' rehabilitation goals.Occupational participation and social interaction should be core aspects of stroke rehabilitation.Occupation-focus rehabilitation could provide opportunities for stroke survivors to pursue their desired occupational identity.
Collapse
Affiliation(s)
- Maria M Martin-Saez
- Occupational Therapy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Neil James
- School of Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
20
|
Littooij E, Widdershoven GAM, Leget CJW, Dekker J. Inner posture as aspect of global meaning in healthcare: a conceptual analysis. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2019; 22:201-209. [PMID: 30054860 DOI: 10.1007/s11019-018-9853-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Based on our empirical research on global meaning in people with spinal cord injury and people with stroke, we formulated 'inner posture' as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer's notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.
Collapse
Affiliation(s)
- Elsbeth Littooij
- Amsterdam Rehabilitation Research Center Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.
| | - Guy A M Widdershoven
- Department of Medical Humanities, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| | - Carlo J W Leget
- Department of Care Ethics, University of Humanistic Studies, PO Box 797, 3500 AT, Utrecht, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| |
Collapse
|
21
|
Zhu M, Zhou H, Zhang W, Deng Y, Wang X, Zhang X, Yang L, Li M, Bai X, Lin Z. Stigma experienced by Chinese patients with stroke during inpatient rehabilitation and its correlated factors: a cross-sectional study. Top Stroke Rehabil 2019; 26:342-348. [PMID: 31104577 DOI: 10.1080/10749357.2019.1605759] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Stroke-related stigma can have a negative effect on patients, and is associated with stereotyping, prejudice, and discrimination; however, the exact stigma experienced by patients remains ambiguous. Objectives: To evaluate the stigma experienced by patients with stroke, determine associated factors, and explore relationships between stigma and early rehabilitation. Methods: Overall, we examined 288 patients with stroke. Patient characteristics were determined through medical records and investigations, while stigma status (comprising total stigma, internalized stigma, and enacted stigma), depression level, functional independence, and functional outcome were also assessed. Demographic and clinical characteristics were evaluated through univariate analysis, and significant variables were further analyzed through linear regression. The relationships between stigma and early rehabilitation (depression, functional independence, and functional outcomes) were also analyzed. Results: The sample's total stigma, internalized stigma, and enacted stigma scores were 47.76 ± 18.00, 30.07 ± 12.25, and 17.69 ± 6.37, respectively. Employment status before stroke, caregivers, physical impairment, and number of impairments were all relevant to all types of stigma (P< .05). The regression analysis showed that caregivers and physical impairment are the two main predictors of total, internalized, and enacted stigma (P< .01). The correlation analysis revealed that stigma is associated with depression (r = 0.671 ~ 0.690, P< .001), functional independence (r = -0.562~-0.707, P< .001), and functional outcomes (r = 0.436 ~ 0.637, P< .001). Conclusions: Stigma was moderate, and internalized stigma may be more apparent; therefore, physicians should pay more attention to patients who report or show signs of experiencing stroke-related stigma.
Collapse
Affiliation(s)
- Minfang Zhu
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Hongzhen Zhou
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Weibin Zhang
- b Department of Pathology , Jiangmen Central Hospital , Jiangmen , Guangdong , China.,c Department of Pathology , School of Basic Medical Sciences, Southern Medical University , Guangzhou, Guangdong , China
| | - Yingying Deng
- d Department of Neurosurgery , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Xiaoyan Wang
- d Department of Neurosurgery , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Xiaomei Zhang
- e Department of Neurology , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| | - Lei Yang
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Muling Li
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Xuejie Bai
- a Department of Nursing , Nanfang Hospital, Southern Medical University , Guangzhou , Guangdong , China
| | - Zhenzhou Lin
- e Department of Neurology , Nanfang Hospital, Southern Medical University , Guangzhou, Guangdong , China
| |
Collapse
|
22
|
Yavuz Tatlı İ, Semin Akel B. A controlled study analyzing the temporal activity patterns of individuals with stroke compared to healthy adults. Br J Occup Ther 2019. [DOI: 10.1177/0308022618819996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction The understanding of the temporal pattern of individuals can add a wider perspective to interventions. Therefore, the present study is aimed toward analysis of the temporal activity pattern of individuals with stroke compared to healthy adults. Method This study is a prospective, case–control, analytic research study. The study sample comprised 50 individuals with stroke and 50 individuals without disease, for 80% power with a 5% type 1 error. The Modified Occupational Questionnaire was administered to assess the temporal activity pattern. Individuals identified the activities performed at each hour of the day and data was analyzed. Results The temporal activity pattern of individuals with stroke differed from healthy controls; education and play activities were not part of stroke participants’ daily routines. Also, participation in work, leisure and social participation activities was significantly different for people with stroke compared to healthy controls ( p < 0.01 ). The study group assigned very low values to the activities; the value perceived by individuals differed significantly between groups ( p < 0.01 ). Conclusion Clinicians are in a position to enable individuals’ time use and help to engage them in meaningful activity. Individuals with stroke may benefit from a program focusing on the temporal aspect of activities.
Collapse
Affiliation(s)
- İbrahim Yavuz Tatlı
- Faculty of Health Sciences, Occupational Therapy Department, Hacettepe University, Turkey
- Konya Education and Research Hospital, Turkey
| | - Burcu Semin Akel
- Faculty of Health Sciences, Occupational Therapy Department, Hacettepe University, Turkey
| |
Collapse
|
23
|
Lee D, Mallinson T, Baum CM, Hammel J. Initial psychometric evaluation of the Community Participation Activation Scale. The Canadian Journal of Occupational Therapy 2018; 85:286-296. [DOI: 10.1177/0008417418795297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Current assessments do not capture the dynamic and complex process of managing different individual and environmental factors influencing community participation post-stroke. Purpose. The purpose of this study was to examine the psychometric properties of the Community Participation Activation Scale (CPAS) in persons with stroke. Method. Rating scale structure, unidimensionality, reliability and precision, construct validity, and differential item functioning of the CPAS were examined with 93 community-dwelling people with stroke. Findings. The CPAS consists of 15 action items and 10 attitude items. Person separation reliabilities of the action and attitude domains were .75 and .72, respectively, and internal consistency reliabilities were good (>.80). The CPAS showed low to moderate correlation with community integration and enfranchisement constructs. Implications. The CPAS may be used as an assessment to better understand an individual’s level of activation and to inform individually designed, participation-focused interventions, although it needs further improvement to be used as a clinical measure.
Collapse
|
24
|
McGrath M, Lever S, McCluskey A, Power E. How is sexuality after stroke experienced by stroke survivors and partners of stroke survivors? A systematic review of qualitative studies. Clin Rehabil 2018; 33:293-303. [DOI: 10.1177/0269215518793483] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To synthesise how post-stroke sexuality is experienced by stroke survivors and partners of stroke survivors. Methods: MEDLINE, PubMed, SCOPUS, CINAHL and PsycINFO were searched from inception to May 2018 using a combination of relevant Medical Subject Headings and Free Text Terms. Only papers published in English reporting original qualitative research were included. Methodological quality was assessed using the Critical Appraisal Skills Programme Qualitative Research Checklist. All text presented as ‘results’ or ‘findings’ in the included studies was extracted and subjected to a thematic analysis and synthesis which was discussed and agreed by the research team. Results: The initial search yielded 136 unique papers with a further 8 papers identified through reference checking. Following full-text review, 43 papers were included in the final synthesis. Two analytical themes were identified: sexuality is silenced and sexuality is muted and sometimes changed, but not forgotten. These themes were made up of six descriptive themes: struggle to communicate within relationships, health professionals don’t talk about sexuality, sexuality and disability is a taboo topic, changes to pre-stroke relationships, changed relationship with the stroke survivor’s own body and resuming sexual intimacy – adaptation and loss. Conclusion: Stroke has a profound impact on how sexuality is experienced by both stroke survivors and partners of stroke survivors. Despite this, post-stroke sexuality is rarely discussed openly. Stroke survivors and partners value sexuality and may benefit from strategies to support adjustment to post-stroke sexuality.
Collapse
Affiliation(s)
- Margaret McGrath
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Sandra Lever
- Ryde Sexuality and Intimacy Clinic, Graythwaite Rehabilitation Centre, Ryde Hospital, NSW, Australia
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, M02- Sydney Nursing School, The University of Sydney, NSW, Australia
| | - Annie McCluskey
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| |
Collapse
|
25
|
Lee MA, Shin CN, An K. Trustworthiness, Readability, and Suitability of Web-Based Information for Stroke Prevention and Self-Management for Korean Americans: Critical Evaluation. Interact J Med Res 2018; 7:e10440. [PMID: 30030210 PMCID: PMC6076368 DOI: 10.2196/10440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 01/14/2023] Open
Abstract
Background Websites are common sources of health information to stroke survivors and caregivers for continual management of stroke and its long-term sequelae. The presence of risk factors and mortality rates related to stroke are high in Korean Americans. A vast majority of this group are active Web users and rely on the Web-based information due to lack of insurance and, thus, limited access to long-term stroke care. Thus, it is critical to evaluate existing stroke websites for their trustworthiness, readability, and suitability. Objective The objective of our study was to provide a systematic evaluation of stroke-related websites regarding (1) trustworthiness, (2) readability, and (3) suitability for stroke prevention and self-management for Korean Americans. Methods We selected a total of 156 websites using search terms “stroke,” “CVA,” “중풍 (jungpung),” and “뇌졸증 (noejoljung)” on Google and Yahoo. After eliminating duplicates and irrelevant websites (n=116), we evaluated a total of 42 websites (15 in English and 27 in Korean) using the National Library of Medicine’s health website’s evaluation tool for trustworthiness; Simple Measure of Gobbledygook for readability; and Suitability Assessment of Materials for suitability. All three instruments used the 3-point Likert scale: superior (=2), adequate (=1), or not suitable (=0). Results Of the 42 websites evaluated, we rated 62% (26/42) websites as “adequate” or above for trustworthiness. The information on 48% (20/42) websites had not been updated for more than a year, which indicates poor currency; 33% (14/42) websites failed to provide the publisher and contact information, which yields poor authority; 50% (21/42) websites did not cite sources of health information, which indicates lack of accuracy. Only 2 websites met the recommended readability (5th grade or lower reading level). The suitability was also suboptimal; only 1 website was rated as “superior”; 60% (25/42) websites were “adequate,” and 38% (16/42) were “not suitable.” Most websites were limited in graphical directions, interactive motivations for desired healthy behaviors, and multiple language translations. Conclusions The existing stroke-related websites in either English or Korean are trustworthy and suitable, yet precise citation of evidence-based information will improve trustworthiness. The contents requiring high reading level may set a barrier to the utilization of Web-based health information for Korean Americans with a lower level of education. In addition, supplementing graphical examples, interaction features, and culturally relevant information in multiple languages are the areas for improvement in suitability. The improved features can reduce the reading burden of stroke patients or caregivers and build their confidence when applying the information for stroke management in daily living. These strategies are especially crucial to Korean Americans, who inevitably seek Web-based information to fill the gap between their demand and access to health care for a long-term self-management after a stroke.
Collapse
Affiliation(s)
- Mikyoung A Lee
- College of Nursing, Texas Woman's University, Denton, TX, United States
| | - Cha-Nam Shin
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Kyungeh An
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, VA, United States
| |
Collapse
|
26
|
Abstract
A stroke can have implications for all areas of a person's life. In research on adaptation to stroke, finding meaning is associated with better adaptation. This study focuses on one of the driving principles behind meaning-making processes: global meaning. The aim of this study was to explore whether global meaning (i.e., fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) is associated with processes and outcomes of rehabilitation, as experienced by people with stroke. In-depth, semi-structured interviews were conducted, and analysed using qualitative research methods. Aspects of global meaning were associated with the following elements of process and outcome of rehabilitation: motivation, handling stress and emotions, physical functioning and acceptance. The influence was mostly positive. If rehabilitation professionals took global meaning into account, respondents tended to associate this with better or faster recovery.
Collapse
|
27
|
Atler KE, Van Puymbroeck M, Portz JD, Schmid AA. Participant-perceived outcomes of merging yoga and occupational therapy: Self-management intervention for people post stroke. Br J Occup Ther 2017. [DOI: 10.1177/0308022617690536] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction There is a need for development and validation of post-stroke fall-prevention programs. This qualitative study provides an inside look into participant-perceived outcomes of a new and innovative self-management intervention: Merging Yoga and Occupational Therapy. Method A qualitative approach was employed. Thirteen participants, who were more than 6 months post stroke and self-reported falling or a fear of falling, engaged in focus groups and individual interviews following participation in the intervention twice weekly for 8 weeks. Data from focus groups and individual interviews were analyzed using an iterative, inductive approach. Findings Five outcomes emerged from the line-by-line analysis: (1) improved abilities and capacities, (2) gained new knowledge, (3) enhanced engagement in activities, (4) improved relaxation, and (5) increased confidence and inspiration. Conclusion Participants experienced positive outcomes from engagement in a community-based multimodal fall-prevention self-management program for people post stroke.
Collapse
Affiliation(s)
- Karen E Atler
- Assistant Professor, Department of Occupational Therapy, Colorado State University, Fort Collins, USA
| | - Marieke Van Puymbroeck
- Professor, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, USA
| | - Jennifer D Portz
- Assistant Professor, School of Social Work, Colorado State University, Fort Collins, USA
| | - Arlene A Schmid
- Associate Professor, Department of Occupational Therapy, Colorado State University, Fort Collins, USA
| |
Collapse
|
28
|
Pucciarelli G, Vellone E, Savini S, Simeone S, Ausili D, Alvaro R, Lee CS, Lyons KS. Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke: A Longitudinal Dyadic Analysis. Stroke 2017; 48:733-739. [PMID: 28196939 DOI: 10.1161/strokeaha.116.014989] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/09/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to examine changes in stroke survivor and caregiver quality of life (QOL) and to determine whether changes in survivor physical functioning and caregiver burden (ie, the impact of the physical, psychological, and social demands of caregiving) influence changes in QOL. METHODS Longitudinal design with 226 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor physical functioning, caregiver burden, and QOL (physical, psychological, social, and environmental) in both survivor and caregiver. Multilevel modeling was used to control for the interdependence of the data. RESULTS Survivors (50% male sex) and caregivers (66% female sex) were 70.8 (SD=11.9) and 52.4 (SD=13.1) years old, respectively. Over the 12 months, stroke survivor's physical (γ=1.59; P<0.001) and psychological (γ=0.86; P<0.05) QOL significantly improved; social and environmental QOL did not P>0.05. Caregiver QOL, on average, did not significantly change over time P>0.05. Improvements in survivor physical functioning were associated with increases in survivor and caregiver physical and psychological QOL and survivor environmental QOL. Decreases in caregiver burden were significantly associated with improvements in caregiver physical, psychological, and environmental QOL but not with survivor QOL. CONCLUSIONS QOL of stroke survivors and caregivers covaries and is greatly impacted by the physical function changes of the survivor. Dyadic approaches to stroke rehabilitation that acknowledge the interdependence of dyads are needed.
Collapse
Affiliation(s)
- Gianluca Pucciarelli
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
| | - Ercole Vellone
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Serenella Savini
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Silvio Simeone
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Davide Ausili
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Rosaria Alvaro
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Christopher S Lee
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| | - Karen S Lyons
- From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.)
| |
Collapse
|
29
|
Sarfo FS, Nichols M, Qanungo S, Teklehaimanot A, Singh A, Mensah N, Saulson R, Gebregziabher M, Ezinne U, Owolabi M, Jenkins C, Ovbiagele B. Stroke-related stigma among West Africans: Patterns and predictors. J Neurol Sci 2017; 375:270-274. [PMID: 28320146 DOI: 10.1016/j.jns.2017.02.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/27/2017] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. OBJECTIVE To assess the prevalence, severity, determinants and psycho-social consequences of stigma among LMIC stroke survivors. METHODS Between November 2015 and February 2016, we conducted a cross-sectional survey of 200 consecutive stroke survivors attending a neurology clinic in a tertiary medical center in Ghana. The validated 8-Item Stigma Scale for Chronic Illness (SSCI-8) questionnaire was administered to study participants to assess internalized and enacted domains of stigma at the personal dimension with further adaptation to capture family and community stigma experienced by stroke participants. Responses on the SSCI-8 were scored from 1 to 5 for each item, where 1=never, 2=rarely, 3=sometimes, 4=often and 5=always with a score range of 8-40. Demographic and clinical data on stroke type and severity as well as depression and Health-Related Quality of Life indicators were also collected. Predictors of stroke-related stigma were assessed using Linear Models (GLM) via Proc GENMOD in SAS 9.4. RESULTS 105 (52.5%) subjects recruited were males and the mean±SD age of stroke survivors in this survey was 62.0±14.4years. Mean SSCI-8 score was highest for personal stigma (13.7±5.7), which was significantly higher than family stigma (11.9±4.6; p=0.0005) and social/community stigma (11.4±4.4; p<0.0001). Approximately 80% of the cohort reported experiencing mild-to-moderate degrees of stigma. A graded increase in scores on the Geriatric Depression Scale and Centre for Epidemiological Studies-Depression scale was observed across the three categories. Living in an urban setting was associated with higher SSCI-8 scores. Moreover, stroke subjects with more severe post-stroke residual symptom deficits reported a significantly higher frequency of stigma. CONCLUSION Four out of five stroke survivors in this Ghanaian cohort reported experiencing some form of stigma. Stigmatized individuals were also more likely to be depressed and have lower levels of quality of life. Further studies are required to assess the consequences of stigma from stroke in LMIC.
Collapse
Affiliation(s)
- Fred Stephen Sarfo
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
| | | | | | | | - Arti Singh
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Littooij E, Dekker J, Vloothuis J, Leget CJ, Widdershoven GA. Global meaning in people with stroke: Content and changes. Health Psychol Open 2016; 3:2055102916681759. [PMID: 28815054 PMCID: PMC5221737 DOI: 10.1177/2055102916681759] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
After a traumatic event like a stroke, people need to find meaning and control again. This study enhances knowledge on one of the driving principles behind meaning-making processes: global meaning. Global meaning refers to individuals' general orienting systems, comprising fundamental beliefs and life goals. Little is known about global meaning in people with stroke and whether global meaning changes after stroke. In this qualitative study, five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. Continuity in all aspects was reported, but worldview, identity and inner posture were also subjected to change.
Collapse
Affiliation(s)
| | - Joost Dekker
- Amsterdam Rehabilitation Research Center Reade, The Netherlands.,VU University Medical Center, The Netherlands.,EMGO Institute for Health and Care Research, The Netherlands
| | | | | | - Guy Am Widdershoven
- VU University Medical Center, The Netherlands.,EMGO Institute for Health and Care Research, The Netherlands
| |
Collapse
|
31
|
Jellema S, van Hees S, Zajec J, van der Sande R, Nijhuis-van der Sanden MW, Steultjens EM. What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings. Clin Rehabil 2016; 31:936-947. [PMID: 27681480 PMCID: PMC5482381 DOI: 10.1177/0269215516671013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. DATA SOURCES PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. REVIEW METHODS An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. RESULTS The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. CONCLUSION A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.
Collapse
Affiliation(s)
- Sandra Jellema
- 1 Radboud university medical center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands
| | - Suzanne van Hees
- 3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Jana Zajec
- 3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Rob van der Sande
- 2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands.,4 Radboud university medical center, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- 1 Radboud university medical center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands.,3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Esther Mj Steultjens
- 2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands
| |
Collapse
|
32
|
Family Caregivers’ Experiences of Stroke Recovery Among Older Adults Living in Iran: A Qualitative Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.27686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
33
|
Lai JS, Hammel J, Jerousek S, Goldsmith A, Miskovic A, Baum C, Wong AW, Dashner J, Heinemann AW. An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities. Arch Phys Med Rehabil 2016; 97:2102-2112. [PMID: 27422348 DOI: 10.1016/j.apmr.2016.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/18/2016] [Accepted: 06/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. DESIGN Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. SETTING Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. PARTICIPANTS Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. RESULTS We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. CONCLUSIONS The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation.
Collapse
Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Joy Hammel
- Department of Occupational Therapy, University of Illinois, Chicago, Chicago, IL
| | - Sara Jerousek
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL
| | - Arielle Goldsmith
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL
| | - Carolyn Baum
- Program in Occupational Therapy, Washington University, St Louis, MO
| | - Alex W Wong
- Program in Occupational Therapy, Washington University, St Louis, MO
| | - Jessica Dashner
- Program in Occupational Therapy, Washington University, St Louis, MO
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
34
|
Long-Term Predictors of Social and Leisure Activity 10 Years after Stroke. PLoS One 2016; 11:e0149395. [PMID: 26901501 PMCID: PMC4765767 DOI: 10.1371/journal.pone.0149395] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 02/01/2016] [Indexed: 01/08/2023] Open
Abstract
Background Restrictions in social and leisure activity can have negative consequences for the health and well-being of stroke survivors. To support the growing number of people who are ageing with stroke, knowledge is needed about factors that influence such activity in a long-term perspective. Aim To identify long-term predictors of the frequency of social and leisure activities 10 years after stroke. Method 145 stroke survivors in Sweden were followed-up at16 months and 10 years after a first-ever stroke. Data representing body functions, activities & participation, environmental factors and personal factors at 16 months after stroke, were used in multiple linear regression analyses to identify predictors of the activity frequency after 10 years, as assessed by the ‘Community, social and civic life’ sub-domain of the Frenchay Activities Index (FAI-CSC). Results At the 10-year follow-up the frequency of social and leisure activities varied considerably among the participants, with FAI-CSC scores spanning the entire score range 0–9 (mean/median 4.9/5.0). Several factors at 16 months post stroke were independently related to the long-term activity frequency. The final regression model included four significant explanatory variables. Driving a car (B = 0.999), ability to walk a few hundred meters (B = 1.698) and extent of social network (B = 1.235) had a positive effect on activity frequency, whereas an age ≥ 75 years had a negative effect (B = -1.657). This model explained 36.9% of the variance in the FAI-CSC (p<0.001). Conclusion Stroke survivors who drive a car, have the ability to walk a few hundred meters and have a wide social network at 16 months after a first-ever stroke are more likely to have a high frequency of social and leisure activities after 10 years, indicating that supporting outdoor mobility and social anchorage of stroke survivors during rehabilitation is important to counteract long-term inactivity.
Collapse
|
35
|
Jellema S, van der Sande R, van Hees S, Zajec J, Steultjens EM, Nijhuis-van der Sanden MW. Role of Environmental Factors on Resuming Valued Activities Poststroke: A Systematic Review of Qualitative and Quantitative Findings. Arch Phys Med Rehabil 2016; 97:991-1002.e1. [PMID: 26854855 DOI: 10.1016/j.apmr.2016.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate how reengagement in valued activities poststroke is influenced by environmental factors. DATA SOURCES PubMed, CINAHL, and PsycINFO were searched to June 2015 using multiple search terms for stroke, activities, disability, and home and community environments, with the following constraints: English, humans, and adults. STUDY SELECTION Studies were included that contained data on how reengagement in valued activities of community-dwelling stroke survivors was influenced by the environment. Two reviewers independently selected the studies. The search yielded 3726 records; 39 studies were eventually included. DATA EXTRACTION Findings were extracted from qualitative, quantitative, and mixed-design studies. Two reviewers independently assessed study quality using the Oxford Critical Appraisal Skills Programme lists and independently extracted results. DATA SYNTHESIS Thematic analysis was conducted on qualitative data, revealing 9 themes related to the iterative nature of the process of reengagement and the associated environmental factors. During the process of reengagement, environmental factors interact with personal and disease-related factors in a gradual process of shaping or abandoning valued activities. The sociocultural context in this case determines what activities are valued and can be resumed by stroke survivors. Social support; activity opportunities and obligations; familiar and accessible environments; resources and reminders; and a step-by-step return facilitate stroke survivors to explore, adapt, resume, and maintain their activities. Social support is helpful at all stages of the process and particularly is important in case stroke survivors are fearful to explore their activity possibilities. The quantitative data identified largely endorsed these findings. No quantitative data were found in respect to the iterative nature of the process, familiar environments, or accessibility. CONCLUSIONS Reengagement in valued activities is a gradual process. In each stage of the process, several environmental factors play a role. During rehabilitation, professionals should pay attention to the role physical and social environmental factors have in reengagement poststroke and find ways to optimize stroke survivors' environments.
Collapse
Affiliation(s)
- Sandra Jellema
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Faculty of Health and Social Studies, Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | - Rob van der Sande
- Faculty of Health and Social Studies, Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suzanne van Hees
- Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jana Zajec
- Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esther M Steultjens
- Faculty of Health and Social Studies, Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maria W Nijhuis-van der Sanden
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Faculty of Health and Social Studies, Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
36
|
Northcott S, Moss B, Harrison K, Hilari K. A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change. Clin Rehabil 2015; 30:811-31. [PMID: 26330297 DOI: 10.1177/0269215515602136] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 08/01/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Identify what factors are associated with functional social support and social network post stroke; explore stroke survivors' perspectives on what changes occur and how they are perceived. DATA SOURCES The following electronic databases were systematically searched up to May 2015: Academic Search Complete; CINAHL Plus; E-journals; Health Policy Reference Centre; MEDLINE; PsycARTICLES; PsycINFO; and SocINDEX. REVIEW METHODS PRISMA guidelines were followed in the conduct and reporting of this review. All included studies were critically appraised using the Critical Appraisal Skills Program tools. Meta-ethnographic techniques were used to integrate findings from the qualitative studies. Given the heterogeneous nature of the quantitative studies, data synthesis was narrative. RESULTS Seventy research reports met the eligibility criteria: 22 qualitative and 48 quantitative reporting on 4,816 stroke survivors. The qualitative studies described a contraction of the social network, with non-kin contact being vulnerable. Although family were more robust network members, significant strain was observed within the family unit. In the quantitative studies, poor functional social support was associated with depression (13/14 studies), reduced quality of life (6/6 studies) and worse physical recovery (2/2 studies). Reduced social network was associated with depression (7/8 studies), severity of disability (2/2 studies) and aphasia (2/2 studies). Although most indicators of social network reduced post stroke (for example, contact with friends, 5/5 studies), the perception of feeling supported remained relatively stable (4/4 studies). CONCLUSION Following a stroke non-kin contact is vulnerable, strain is observed within the family unit, and poor social support is associated with depressive symptoms.
Collapse
Affiliation(s)
- Sarah Northcott
- Division of Language and Communication Science, School of Health Sciences, City University London, UK
| | - Becky Moss
- Division of Language and Communication Science, School of Health Sciences, City University London, UK
| | - Kirsty Harrison
- Division of Language and Communication Science, School of Health Sciences, City University London, UK
| | - Katerina Hilari
- Division of Language and Communication Science, School of Health Sciences, City University London, UK
| |
Collapse
|
37
|
|
38
|
Johansson M, Ahlström G, Jönsson AC. Living with companion animals after stroke: experiences of older people in community and primary care nursing. Br J Community Nurs 2015; 19:578-84. [PMID: 25475671 DOI: 10.12968/bjcn.2014.19.12.578] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Older people often have companion animals, and the significance of animals in human lives should be considered by nurses-particularly in relation to older people's health, which can be affected by diseases. The incidence of stroke increases with age and disabilities as a result of stroke are common. This study aimed to explore older people's experiences of living with companion animals after stroke, and their life situation with the animals in relation to the physical, psychological and social aspects of recovery after stroke. The study was performed using individual interviews approximately 2 years after stroke with 17 participants (10 women and 7 men) aged 62-88 years. An overarching theme arising from the content analysis was contribution to a meaningful life. This theme was generated from four categories: motivation for physical and psychosocial recovery after stroke; someone to care for who cares for you; animals as family members; and providers of safety and protection. The main conclusion was that companion animals are experienced as physical and psychosocial contributors to recovery and a meaningful life after stroke.
Collapse
Affiliation(s)
- Maria Johansson
- Doctoral Student, Department of Health Sciences, Lund University, Lund, Sweden
| | | | | |
Collapse
|
39
|
Soundy A, Stubbs B, Roskell C. The experience of Parkinson's disease: a systematic review and meta-ethnography. ScientificWorldJournal 2014; 2014:613592. [PMID: 25525623 PMCID: PMC4265687 DOI: 10.1155/2014/613592] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/17/2022] Open
Abstract
There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson's disease. Bringing this information together would provide a background to understand the importance of an individual's social identity on their well-being and hope. Three primary aims were identified (a) understanding the importance of social identity and meaningful activities on individuals' well-being, (b) identifying factors and strategies that influence well-being and hope, and (c) establishing a model that relates to an individual's hope and well-being. Three stages were undertaken including a traditional electronic search, a critical appraisal of articles, and a synthesis of studies. Qualitative articles were included that considered the experience of living with Parkinson's disease. Thirty seven articles were located and included in the review. Five themes were identified and the themes were used to inform development of a new model of hope enablement. The current review furthered understanding of how physical symptoms and the experience of Parkinson's disease affect the individual's well-being and hope. Social identity was established as a key factor that influenced an individual's well-being. Being able to maintain, retain, or develop social identities was essential for the well-being and hope of individuals with Parkinson's disease. Understanding the factors which prevent or can facilitate this is essential.
Collapse
Affiliation(s)
- Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London SE9 2UG, UK
| | - Carolyn Roskell
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
40
|
Nanninga CS, Meijering L, Schönherr MC, Postema K, Lettinga AT. Place attachment in stroke rehabilitation: a transdisciplinary encounter between cultural geography, environmental psychology and rehabilitation medicine. Disabil Rehabil 2014; 37:1125-34. [DOI: 10.3109/09638288.2014.955136] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
41
|
Identifying a Framework for Hope in Order to Establish the Importance of Generalised Hopes for Individuals Who Have Suffered a Stroke. Adv Med 2014; 2014:471874. [PMID: 26556412 PMCID: PMC4590961 DOI: 10.1155/2014/471874] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/06/2014] [Accepted: 06/01/2014] [Indexed: 11/25/2022] Open
Abstract
Hope and hopelessness are important psychological constructs that physiotherapists should consider when working with patients who have experienced a stroke. The view of hope in rehabilitation is often focused around the concept of goals and how hope works within this framework. However, the current paper proposes a broader framework for hope and the importance of a more generalised view of understanding why a certain hope exists or is identified by a patient. A narrative review using an a priori thematic analysis was undertaken to consider how more generalised hopes are expressed by individuals who have suffered a stroke. An electronic search of 4 databases from inception until April 2014 was undertaken. Qualitative articles were included if they considered the concept of hope for patients who had suffered a stroke. The results identified three themes which included (1) consideration of the patient's identity/identities, (2) meaningful activities, experiences, and interactions, and (3) the experience of suffering and need for relief. An awareness of patients' generalised hopes should be a priority for HCPs. Detailed implications for HCPs are identified within the discussion.
Collapse
|