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Šaňáková Š, Gurková E, Štureková L, Bartoníčková D, Machálková L, Mazalová L. How to return? experiences of patients in working age after first Ischaemic stroke: an interpretative phenomenological analysis of patient´s perspective at 12 - 24 months post-stroke. Int J Qual Stud Health Well-being 2024; 19:2398249. [PMID: 39229807 PMCID: PMC11376287 DOI: 10.1080/17482631.2024.2398249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Limited evidence of young adult patient-reported outcomes and experiences after ischaemic stroke has been conducted. AIM To investigate the meaning of the lived experiences of stroke patients in working age 12-24 months after their first IS. MATERIAL AND METHODS The exploratory qualitative study used an interpretative phenomenological analysis (IPA) design. Nine ischaemic stroke patients (with age ranges from 41 to 50 years) took part in semi-structured qualitative interviews. RESULTS Even with mild residual neurological deficit, IS negatively impacted the quality of life daily and social life. Six subthemes and three interconnected group experiential themes were generated: (i) From confusion to understanding (ii) Triggers for rebuilding; and (iii) Challenges and benefits. CONCLUSION The study highlights the current gaps and limitations in supporting the needs of stroke patients in working age in long-term post-stroke care. The findings are crucial for healthcare professionals to develop improved age- and mild- impairment-appropriate strategies or tailor self-management interventions for stroke patients of working age.ClinicalTrials.gov: NCT04839887.
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Affiliation(s)
- Šárka Šaňáková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Štureková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Machálková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Mazalová
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
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Huang V, Marais O, Mortenson WB, Nadeau J, Arsenault S, Field TS, De Sousa I. "I just kept asking and asking and there was nothing": re-thinking community resources & supports for young adult stroke survivors. Disabil Rehabil 2024:1-10. [PMID: 39317344 DOI: 10.1080/09638288.2024.2404185] [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: 07/08/2024] [Revised: 09/08/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE Stroke is often regarded as a disease of the elderly. However, 10-15% of strokes occur in people aged 18 to 50, and rates continue to rise. Young stroke survivors face unique challenges due to their occupational, family and personal commitments, which current stroke rehabilitation services may not fully address. Our qualitative study aimed to identify gaps in patient care and resources for young stroke survivors. We used these findings to develop recommendations to inform clinical care, healthcare system design, and health policy. METHODS Using Interpretive Description, we conducted semi-structured interviews with 19 stroke survivors aged 18-55 living in British Columbia, Canada, to explore their experiences during stroke recovery and assess current gaps in support and resources. We applied broad-based coding and thematic analysis to the transcripts. RESULTS Key themes included: (1) the need for longitudinal medical follow-up and information provision, (2) the need for psychological/psychiatric care, (3) the need to adapt community supports and resources to young survivors, and (4) the need to centralize and integrate community stroke services and resources. CONCLUSION Young stroke survivors experience unique challenges and lack appropriate services and resources. Many of our findings may be representative of remediable gaps that persist nationally and internationally.
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Affiliation(s)
- Vivian Huang
- Division of Physical Medicine and Rehabilitation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Olivia Marais
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sacha Arsenault
- Stroke Services BC, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Thalia S Field
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Stroke Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Ismalia De Sousa
- Vancouver Stroke Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
- School of Nursing-Vancouver, University of British Columbia, Vancouver, British Columbia, Canada
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Nakamura T, Kurosaki S, Baba M, Irisawa H, Mizushima T. Effectiveness of rehabilitation for young patients with extensive right hemisphere cerebral infarction: A report of two cases. Clin Case Rep 2024; 12:e9328. [PMID: 39135767 PMCID: PMC11317890 DOI: 10.1002/ccr3.9328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
Key Clinical Message In younger patients, including those with extensive infarction involving the anterior and middle cerebral artery regions of the right hemisphere, appropriate treatment for rare causes and goal-oriented long-term rehabilitation could improve severe hemiplegia and higher brain dysfunction, and allow for further education and employment. Abstract Although the number of young stroke patients is small, many have serious sequelae and rare causes. In addition to independence in activities of daily living, education and employment are desired. We present two cases of extensive infarction in the right cerebrum in patients who underwent rehabilitation with good outcomes.
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Affiliation(s)
- Tomoyuki Nakamura
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Shuhei Kurosaki
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Mikoto Baba
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Hiroshi Irisawa
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
| | - Takashi Mizushima
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
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Bartoníčková D, Gurková E, Zeleníková R, Kalafutová S. Return to work after ischaemic stroke in young adults: a scoping review. Cent Eur J Public Health 2024; 32:108-118. [PMID: 39069314 DOI: 10.21101/cejph.a7936] [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: 06/21/2023] [Accepted: 05/12/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES The aim of the study was to synthesize the body of knowledge on the factors that are important to the process of returning to work after ischaemic stroke in young adults under 55 years of age. METHODS Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA checklist for scoping reviews were used. A total of 2,249 studies were identified through a bibliographic search in six databases. RESULTS A total of ten studies were finally selected to respond to the research questions. Eight studies were quantitative observational studies, and two studies had a case study design. The rate of returning to work varied between the studies. The frequency of returning to work in young stroke patients, independent of the time of assessment, ranged from 42.4% to 86%. Returning to work after ischaemic stroke in young adults is a complex process and multidimensional problem which is affected by clinical variables (level of neurological deficits, cognitive ability, independency in activities of daily living, fatigue and depression, cardiovascular factors), as well as the socioeconomic and occupational status. CONCLUSION There is insufficient evidence concerning interventions promoting return to work. Future studies should focus on examining effective interventions to help young stroke survivors return to work.
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Affiliation(s)
- Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Soňa Kalafutová
- Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Presov, Presov, Slovak Republic
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Faccio E, Fonte C, Smania N, Neri J. (Re)constructing identity following acquired brain injury: The complex journey of recovery after stroke. Health Expect 2024; 27:e13874. [PMID: 37731198 PMCID: PMC10726149 DOI: 10.1111/hex.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION People with poststroke acquired brain injury (ABI) face a complex and often troubled identity reconstruction journey. The literature is rich with studies related to the psychological and neuropsychological components involved in rehabilitation, but it is lacking with respect to the investigation of the existential dimensions and the challenges associated with finding new senses and meanings for one's identity and future perspectives, body and interpersonal relationships. METHODS The aim of this study is to investigate the narrative processes of identity reconstruction after brain damage. Through a qualitative approach, 30 autobiographical narratives about self, body and the relationships with others were collected and analyzed. Semistructured interviews were used for the data collection. Narrative and positioning analysis were applied. RESULTS Four main positionings emerged: sanctioning a radical break with one's previous life; assuming a sense of salvation and compulsory as well as irreversible adaptation to the limitations associated with one's condition; feeling different and disabled; and considering new possibilities and active constructions of self-being in relationship with others. These results underline the narrative processes of construction of the injury and the identity and delineate possible resources and instruments to improve the clinical practice for health practitioners. They are also valuable for other professionals who deal with neurological services and rehabilitation, such as psychological counselling and support for persons who have experienced ABI and their families. PATIENT OR PUBLIC CONTRIBUTION This work resulted from a close collaboration between two universities and a hospital neurological rehabilitation department in the Veneto Region (Northern Italy). Three associations of people with stroke and their families living in the same area contributed to designing the research on the basis of the needs expressed by their members with the aim to identify strategies and devices to be implemented in the public service to improve the care pathway. They also participated in the interpretation of the data.
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Affiliation(s)
- Elena Faccio
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of PaduaPaduaItaly
| | - Cristina Fonte
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Jessica Neri
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of PaduaPaduaItaly
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Gopaul U, Charalambous M, Thilarajah S, Kwah LK, Chapman S, Bayley M, Demers M. Age-specific information resources to address the needs of young people with stroke: a scoping review protocol. Syst Rev 2022; 11:275. [PMID: 36529833 PMCID: PMC9761956 DOI: 10.1186/s13643-022-02147-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Young people with stroke (YPwS) persistently experience challenges with disability, social reintegration, employment, and financial stability to provide for themselves and their families. The aims of this scoping review are to (1) identify and collate information resources for YPwS and evidence-based self-managements programs and (2) identify gaps in age-specific resources available for YPwS after traditional rehabilitation services have ended and/or who are returning to live in the community. METHODS We will include both qualitative and quantitative studies, including all study designs. Participants will be community-dwelling adults aged between 18 and 65 years with a clinical diagnosis of stroke. We will include information resources and evidence-based self-managements programs for YPwS. Search terms will include stroke, young people, and community dwelling. We will search electronic databases such as MEDLINE. The reference lists of included studies, systematic reviews, and stroke guidelines and stroke-specific websites will also be searched. We will also contact Stroke Support Organizations and international/national allied health professional organisations to gather information resources about YPwS. We will also conduct a comprehensive environmental scan of additional resources using the search engine Google. The titles, abstracts, full-text articles, and contents of the resources identified by the search will be assessed against the inclusion and exclusion criteria to identify potentially relevant resources. RESULTS AND CONCLUSIONS Existing resources and self-management programs will be collated and categorized according to the type of needs addressed such as physical, emotions, activities of daily living, information, relationships, and social needs as well as the key gaps identified.
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Affiliation(s)
- U Gopaul
- The KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Canada.
| | - M Charalambous
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Rehabilitation Sciences Department, Cyprus University of Technology, Limassol, Cyprus
| | - S Thilarajah
- Department of Physiotherapy, Singapore General Hospital, Bukit Merah, Singapore
| | - L K Kwah
- Health and Social Sciences Cluster, Singapore Institute of Technology, Dover, Singapore
| | - S Chapman
- University of Virginia Comprehensive Stroke Center, Charlottesville, USA
| | - M Bayley
- The KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Canada
| | - M Demers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, USA
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