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Zhou Z, Jiang W, Liu M, Xue T, Li X, Jiang Y. The relationship between family resilience, post-traumatic growth, and caregiver burden among family caregivers of stroke survivors: a cross-sectional study. PSYCHOL HEALTH MED 2024:1-14. [PMID: 38712657 DOI: 10.1080/13548506.2024.2350701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The study aimed to explore the relationship between family resilience, post-traumatic growth(PTG), and caregiver burden among family caregivers of stroke survivors. Researchers conducted a cross-sectional study to recruit 253 family caregivers of stroke survivors from a public hospital in Shandong Province, China. Caregivers completed sociodemographic information, the Shortened Chinese Version of the Family Resilience Assessment Scale, the Post-traumatic Growth Inventory, and the Zarit Caregiver Burden Interview. We used Amos 24.0 to construct structural equation models and examine the mediating effects of stroke survivors' post-traumatic growth. Family resilience was positively associated with post-traumatic growth, and both family resilience and post-traumatic growth were negatively associated with caregiver burden. Post-traumatic growth partially mediated the relationship between family resilience and caregiver burden, and the mediating effect accounted for 21.27% of the total effect. Targeted interventions should address family resilience and post-traumatic growth as protective factors of caregiver burden.
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Affiliation(s)
- Zhenfeng Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Wenbin Jiang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meiyan Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Ting Xue
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao Li
- School of Nursing, Qingdao University, Qingdao, China
| | - Yongmei Jiang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
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Bal C, Koç Z. Technology-Based Health Promotion Training Among Stroke Patients: A Randomized Controlled Trial. Clin Nurs Res 2024; 33:81-94. [PMID: 38047449 DOI: 10.1177/10547738231211980] [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] [Indexed: 12/05/2023]
Abstract
Stroke is a disease with a heavy social and familial care burden that can cause permanent brain damage, long-term disability, and/or death. This study aimed to determine the effect of technology-based health promotion training on the daily life activities, quality of life, and self-care of stroke patients. The study design was a Randomized Controlled Trial. The study sample included persons diagnosed with stroke diagnosed with stroke and were receiving inpatient treatment in the neurology clinic of a university hospital. The sample size was calculated as a total of 70 patients, 35 interventions and 35 controls. The intervention group patients received telephone-based education and follow-up grounded in Orem's Self-Care Theory over a 12-week period subsequent to their discharge. The educational content was divided into three distinct categories: self-care needs with regard to health deviations, developmental self-care needs, and universal self-care practices. Data were collected using the Montreal Cognitive Assessment Scale, the Katz Index of Independence in Activities of Daily Living, Stroke-Specific Quality of Life Scale, and the Exercise of Self-Care Agency Scale. The Independent Sample T-Test was used for intergroup comparisons, and the Dependent Sample T-Test was used for intragroup pre-test and post-test comparisons. Independent variables affecting the post-test scores, such as age and gender, were analyzed using the multiple linear regression model. The scale sub-dimension variables were compared using the multivariate analysis of variance test according to the groups. When compared with the control group patients after the training, it was determined that there was a statistically significant difference in the intervention group patients' mean scores for the Stroke-Specific Quality of Life Scale (t = 11.136, p = .001) and the Exercise of Self-Care Agency Scale (t = 14.358, p = .000). Training interventions led to enhanced awareness and knowledge about stroke among the intervention group patients. They also fostered the development of healthier lifestyle behaviors and bolstered both self-care abilities and quality of life.
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Affiliation(s)
- Cansev Bal
- Ondokuz Mayıs University, Samsun, Turkey
| | - Zeliha Koç
- Ondokuz Mayıs University, Samsun, Turkey
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Effect of an individualized digital coaching program on swallowing function in stroke patients. Acta Neurol Belg 2022:10.1007/s13760-022-02153-2. [DOI: 10.1007/s13760-022-02153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
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Wu W, Zhang Y, Zhang Y, Peng B, Xu W. Clinical Effectiveness of Home-Based Telerehabilitation Program for Geriatric Hip Fracture Following Total Hip Replacement. Orthop Surg 2022; 15:423-431. [PMID: 36448261 PMCID: PMC9891946 DOI: 10.1111/os.13521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 08/08/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of a six-month home-based telerehabilitation based on the Internet-based rehabilitation management system coupled with conventional outpatient care in elderly patients with hip fractures following total hip replacement (THR). METHODS Elderly patients (aged over 65 years) with first hip fractures who underwent THR between March 2018 and September 2018 in Tianjin Hospital were enrolled in this study. Patients were divided into two groups: telerehabilitation group (n = 43) and telephone group (n = 42). A Internet-based telerehabilitation management system was established and applied on patients in the telerehabilitation group. For patients in the telephone group, the rehabilitation intervention was administered through conventional outpatient care (telephone along with outpatient follow-up). Data from the Harris hip scale (HHS), functional independence measure (FIM), self-rating anxiety scale (SAS), and postoperative complications at 1, 3, and 6 months after surgery were collected and compared between the two groups. RESULTS A total of 85 elderly patients completed the 6-month follow-up assessment. Results showed that the HHS score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (66.35 ± 4.63 vs 63.48 ± 4.49), 3 months (76.33 ± 4.52 vs 71.81 ± 3.84), and 6 months (84.23 ± 3.13 vs 77.29 ± 4.95) after surgery (P < 0.001). The FIM score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (89.00 ± 5.63 vs 73.35 ± 8.70), 3 months (100.16 ± 4.56 vs 92.81 ± 5.17), and 6 months (111.70 ± 3.13 vs 98.64 ± 5.12) after surgery (P < 0.001). The SAS score was significantly lower in the telerehabilitation group than in the telephone group at 1 month (42.40 ± 3.07 vs 46.21 ± 3.53), 3 months (36.77 ± 2.26 vs 40.24 ± 1.66), and 6 months (29.26 ± 1.63 vs 33.81 ± 2.62) after surgery (P < 0.001). The overall complication rate was significantly lower in the telerehabilitation group than in the telephone group (14% vs 40.5%) (P < 0.05). CONCLUSION Internet-based rehabilitation management system can not only promote the physical rehabilitation of patients, but also play a positive role in psychological rehabilitation and the prevention of complications, which provides new ideas and methods for clinical rehabilitation.
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Affiliation(s)
- Wei‐yong Wu
- Department of OrthopaedicsTianjin HospitalTianjinChina
| | | | | | - Bing Peng
- Department of OrthopaedicsTianjin HospitalTianjinChina
| | - Wei‐guo Xu
- Department of OrthopaedicsTianjin HospitalTianjinChina
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Wang S, You J, Lin J, Fu X, Ning M, Mo Y, Yang S. Effects of the nurse-led program on disabilities improvement in patients with ischemic stroke. Medicine (Baltimore) 2022; 101:e30652. [PMID: 36123853 PMCID: PMC9478287 DOI: 10.1097/md.0000000000030652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
To evaluate whether the nurse-led program can improve disabilities in patients with ischemic stroke for more than 6 months. This is a randomized, open-label study. Participants in the usual-care group received the usual care that included verbal stroke-related education and secondary prevention. Participants in the active group received the usual care plus the nurse-led program intervention. The disability was evaluated using National Institutes of Health Stroke Scale (NIHSS). The Mental Health Inventory-5 (MHI-5) was used to assess mental health status (MHS). The median duration since ischemic stroke was 8.4 and 8.6 months, respectively. At baseline, there was no difference in the median NIHSS value and the NIHSS category between these 2 groups. After 6 months' follow-up, the median NIHSS value was lower in the active group (4.1 vs 6.3). The proportion of patients with NIHSS of 1 to 4 was higher (50.0% vs 28.6%) while the proportion of patients with NIHSS of 5 to 12 (24.1% vs 51.8%) was lower in the active group. After multivariate regression analysis, the nurse-led program was negatively associated with increased NIHSS category (odds ratio of 0.70 and 95% confidence interval of 0.62-0.88). In the group with MHI-5 less than median, the nurse-led program was not associated with NIHSS category. While in the group with MHI-5 greater than median, the nurse-led program was associated decreased NIHSS category, with a significant interaction (P value = .03). In ischemic stroke patients for more than 6 months, the nurse-led program improves disabilities, which might be related to MHS improvement.
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Affiliation(s)
- Suping Wang
- Department of Nursing, Hainan Geriatric Hospital, Hainan, China
- *Correspondence: Suping Wang, Department of Nursing, Hainan Geriatric Hospital, Haikou, 571100, Hainan, China (e-mail: )
| | - Jingyan You
- Department of Nursing, Hainan Western Central Hospital, Hainan, China
| | - Jing Lin
- Department of Nursing, Hainan Geriatric Hospital, Hainan, China
| | - Xiumei Fu
- Department of Nursing, Hainan Geriatric Hospital, Hainan, China
| | - Min Ning
- Department of Nursing, Hainan Geriatric Hospital, Hainan, China
| | - Yuzhu Mo
- Department of Nursing, Hainan Western Central Hospital, Hainan, China
| | - Shoujiao Yang
- Department of Nursing, Hainan Western Central Hospital, Hainan, China
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Huang L, Peng S. Status Quo and Influencing Factors of Discharge Readiness of Patients with Bilateral Ureteral Stoma After Radical Cystectomy. Front Surg 2022; 9:860162. [PMID: 36034344 PMCID: PMC9407034 DOI: 10.3389/fsurg.2022.860162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Bladder cancer is a common malignancy of the urinary system, which occurs mostly in elderly men, and the incidence is increasing year by year. To analyze the status quo and related factors of discharge readiness of patients with bilateral ureteral stoma after radical cystectomy, a retrospective, noncomparative was performed. 544 patients with bilateral ureteral stoma after radical cystectomy in our hospital from December 2018 to December 2020 were selected. The self-designed questionnaire, discharge readiness scale (RHDS) and discharge guidance quality scale (QDTS) were used to investigate the general data, and multiple linear regression was used to analyze the related influencing factors. The total score of RHDS was (72.57 ± 18.56) and the total score of QDTS was (105.63 ± 24.18); the total score of RHDS was positively correlated with the total score of QDTS (r = 0.882, p = 0.000); the results of multiple linear regression showed that age, discharge direction and care mode were the main factors influencing the discharge readiness of patients (p < 0.05). In conclusions, the discharge readiness of patients with bilateral ureteral stoma after radical cystectomy is in the medium level, and there is a large space for improvement. Nurses should strengthen the guidance and nursing of patients’ discharge preparation to reduce the incidence of postoperative complications and readmission rate.
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Lin S, Xiao LD, Chamberlain D, Ullah S, Wang Y, Shen Y, Chen Z, Wu M. Nurse-led health coaching programme to improve hospital-to-home transitional care for stroke survivors: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2022; 105:917-925. [PMID: 34294494 DOI: 10.1016/j.pec.2021.07.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the effects of a nurse-led health coaching programme for stroke survivors and family caregivers in hospital-to-home transition care. METHODS A total of 140 dyads of stroke survivors and their family caregivers were recruited and randomly assigned to either the intervention group (received a 12-week nurse-led health coaching programme) or the usual care group. The primary outcome was self-efficacy, and secondary outcomes were quality of life (QoL), stroke-related knowledge, and caregiver-related burden. The outcomes were measured at baseline, 12 and 24 weeks. RESULTS Stroke survivors in the intervention group demonstrated a significant improvement in self-efficacy at 12 weeks (x̅: 24.9, 95%CI: 20.2-29.6, p < 0.001) and at 24 weeks (x̅: 23.9, 95%CI: 19.2-28.6, p < 0.001) compared to the usual care group. Findings also demonstrated significant increases in stroke survivors' QoL, stroke-related knowledge, and reduction in unplanned hospital readmissions and caregiver-related burden. There were no statistically significant changes in other outcomes between the two groups. CONCLUSION The nurse-led health coaching programme improved health outcomes for both stroke survivors and their caregivers. PRACTICE IMPACTION Findings from the study suggest that nurse-led health coaching should be incorporated into routine practice in hospital-to-home transitional care for stroke survivors and their caregivers.
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Affiliation(s)
- Shuanglan Lin
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Australia
| | - Yanjiang Wang
- Department of Neurology and Centre for Clinical Neuroscience, the Third Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yingying Shen
- Department of Neurology and Centre for Clinical Neuroscience, the Third Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhenfang Chen
- Department of Neurology and Centre for Clinical Neuroscience, the First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Min Wu
- Department of Neurology and Centre for Clinical Neuroscience, the First Affiliated Hospital of Army Medical University, Chongqing, China
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Zimmerman WD, Grenier RE, Palka SV, Monacci KJ, Lantzy AK, Leutbecker JA, Geng X, Denny MC. Transitions of Care Coordination Intervention Identifies Barriers to Discharge in Hospitalized Stroke Patients. Front Neurol 2021; 12:573294. [PMID: 34079506 PMCID: PMC8165227 DOI: 10.3389/fneur.2021.573294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 04/08/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Prolonged hospital lengths of stay increase costs, delay rehabilitation, and expose acute ischemic stroke patients to hospital-acquired infections. We designed and implemented a nurse-driven transitions of care coordinator (TOCC) program to facilitate the transition of care from the acute care hospital setting to rehabilitation centers and home. Methods: This was a single-blinded, prospective, randomized pilot study of 40 participants to evaluate the feasibility of implementing a TOCC program led by a stroke nurse navigator in hospitalized acute ischemic stroke patients. The intervention consisted of a stroke nurse navigator completing eight specific tasks, including meeting with stroke patients and their families, facilitating communication between team members at multi-disciplinary rounds, assisting with referrals to rehabilitation facilities, providing stroke education, and arranging stroke clinic follow-up appointments, which were confirmed to be completed by independent study personnel. The primary outcome was to assess the feasibility of the program. The secondary outcomes included comparing hospital length of stay (LOS) and patient satisfaction between the TOCC and usual care groups. We also explored the association between patient-level variables and LOS. Results: The TOCC program was feasible with all pre-specified components completed in 84.2% (95% CI: 60.4–96.6%) and was not significantly different from the assumed completion rate of 75% (p = 0.438). There was no significant difference in median LOS between the two groups [TOCC 5.95 days (4.02, 9.57) vs. usual care 4.01 days (2.00, 10.45), false discovery rate (FDR)-adjusted p = 0.138]. There was a trend toward higher patient median satisfaction in the TOCC group [TOCC 35.00 (33.00, 35.00) vs. usual care 30 (26.00, 35.00), FDR-adjusted p = 0.1] as assessed by a questionnaire at 30 days after discharge. The TOCC study allowed us to identify patient variables (gender, insurance, stroke severity, and discharge disposition) that were significantly associated with longer hospital LOS. Conclusion: A TOCC program is feasible and can serve as a guide for future allocation of resources to facilitate transitions of care and avoid prolonged hospital stays.
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Affiliation(s)
| | - Rachel E Grenier
- Massachusetts General Hospital, Interventional Radiology, Boston, MA, United States
| | - Sydney V Palka
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Kelsey J Monacci
- Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Amanda K Lantzy
- Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Jacqueline A Leutbecker
- Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Xue Geng
- Department of Biostatistics, Bioinformatics and Biomathematics at Georgetown University Medical Center and Lombardi Comprehensive Cancer Center, Washington, DC, United States
| | - Mary Carter Denny
- Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, United States
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Lin S, Xiao LD, Chamberlain D. Correction to: A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial. Trials 2020; 21:700. [PMID: 32758281 PMCID: PMC7409504 DOI: 10.1186/s13063-020-04609-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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