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Højgaard Nejst C, Glintborg C. Hope as experienced by people with acquired brain injury in a rehabilitation-or recovery process: a qualitative systematic review and thematic synthesis. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1376895. [PMID: 38807900 PMCID: PMC11131419 DOI: 10.3389/fresc.2024.1376895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/26/2024] [Indexed: 05/30/2024]
Abstract
Background There has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI. Methods A qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology. Results Through a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills. Conclusion This review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.
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Affiliation(s)
- Camilla Højgaard Nejst
- Neurorehabilitation Copenhagen, Municipality of Copenhagen, Copenhagen, Denmark
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Chalotte Glintborg
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
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Sun B, Wang N, Li K, Yang Y, Zhang F. The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke. BMC Psychiatry 2024; 24:340. [PMID: 38715019 PMCID: PMC11075303 DOI: 10.1186/s12888-024-05744-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/06/2024] [Indexed: 05/12/2024] Open
Abstract
PURPOSE To explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation. METHODS A cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analyzed using structural equation modeling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist. RESULTS A positive relationship was found between social support and psychological resilience (β1 = 0.548), which was mediated by hope (β2 = 0.114), and social support had significant direct effect on resilience (β3 = 0.434). A positive relationship was also found between self-esteem and psychological resilience (β4 = 0.380), which was mediated by hope (β5 = 0.200), and self-esteem had significant direct effect on resilience (β6 = 0.179). CONCLUSION According to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients' social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.
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Affiliation(s)
- Boru Sun
- Emergency Department, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Nan Wang
- Rehabilitation Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ke Li
- Surgery Department, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan Yang
- Nursing Department, Shengjing Hospital China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning, P.R. China.
| | - Fengjiao Zhang
- Teaching Group of Nursing Department, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, P.R. China.
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Saywell NL, Mudge S, Kayes NM, Stavric V, Taylor D. A six-month telerehabilitation programme delivered via readily accessible technology is acceptable to people following stroke: a qualitative study. Physiotherapy 2023; 120:1-9. [PMID: 37352776 DOI: 10.1016/j.physio.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/16/2023] [Accepted: 05/17/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To explore the experiences of participants during a six-month, post-stroke telerehabilitation programme. DESIGN A qualitative descriptive study to investigate participant experiences of ACTIV (Augmented Community Telerehabilitation Intervention), a six-month tailored exercise programme delivered by physiotherapists primarily using readily accessible telecommunication technology. Semi-structured, in-depth interviews were used to collect data, which were analysed using thematic analysis. SETTING Interviews conducted in participants' homes or a community facility. PARTICIPANTS Participants were eligible if they had a stroke in the previous 18 months and had participated in ACTIV. RESULTS Twenty-one participants were interviewed. Four key themes were constructed from the data: 1. 'ACTIV was not what I call physio' (it differed from participants' expectations of physiotherapy, but they reported many positive aspects to the programme). 2. 'There's somebody there' (ongoing support from the physiotherapists helped participants find strategies to continue improving). 3. 'Making progress' (in the face of barriers, small improvements were valued). 4. 'What I really want' (participant goals were frequently more general than therapy goals and involved progress towards getting back to 'normal'). CONCLUSIONS Although ACTIV was not what participants expected from physiotherapy, the majority found contact from a physiotherapist reduced the feeling of being left to struggle alone. Most participants found a programme with minimal face-to-face contact augmented by phone calls and encouraging text messages to be helpful and acceptable. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registration Number: ACTRN12612000464864 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Nicola L Saywell
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | - Suzie Mudge
- Centre for Person Centred Research, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Nicola M Kayes
- Centre for Person Centred Research, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Verna Stavric
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; Centre for Person Centred Research, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Denise Taylor
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
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Heredia-Callejón A, García-Pérez P, Armenta-Peinado JA, Infantes-Rosales MÁ, Rodríguez-Martínez MC. Influence of the Therapeutic Alliance on the Rehabilitation of Stroke: A Systematic Review of Qualitative Studies. J Clin Med 2023; 12:4266. [PMID: 37445301 DOI: 10.3390/jcm12134266] [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: 05/27/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The therapeutic alliance is a fundamental component of rehabilitation in order to achieve effective outcomes. However, what develops, maintains or hinders this relationship has not been sufficiently explored. The aim of this systematic review is to recognize the role of the therapeutic alliance in the neurological rehabilitation process. A search for articles was carried out in the databases PubMed, Web of Science, SCOPUS, CINAHL, APA PsycInfo, OTseeker and Dialnet. They were selected according to the eligibility criteria. Internal quality assessment of the articles was measured with the Consolidated Criteria for Reporting Qualitative Research (COREQ). The systematic review was registered in PROSPERO (ID 346523). The search in the databases identified 1596 articles, from which 9 different studies were finally included in the systematic review, reflecting the limitations of studies in this field. All studies are qualitative, from the point of view of the patients themselves, their relatives and healthcare professionals. The total sample of the included studies is 182 participants (96 health professionals, 76 users and 10 relatives). Semi-structured interviews, focus group discussions and written reflections were mainly used to collect the data. In conclusion, the therapeutic alliance can be an active component in the post-stroke rehabilitation process. Being recognized as a person, collaboration with the therapeutic team, empathy, empowerment, confidence, professional skills, maintenance of hope and the role of the family have been identified as aspects that can have an influence on the therapeutic alliance.
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Affiliation(s)
| | - Patricia García-Pérez
- Occupational Therapy Department, Hospital Marítimo, Servicio Andaluz de Salud (SAS), 29620 Malaga, Spain
| | - Juan Antonio Armenta-Peinado
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Biomedical Research Institute (IBIMA), 29590 Malaga, Spain
| | - Miguel Ángel Infantes-Rosales
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Biomedical Research Institute (IBIMA), 29590 Malaga, Spain
| | - María Carmen Rodríguez-Martínez
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Biomedical Research Institute (IBIMA), 29590 Malaga, Spain
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Kayes NM, Papadimitriou C. Reflecting on challenges and opportunities for the practice of person-centred rehabilitation. Clin Rehabil 2023:2692155231152970. [PMID: 36726297 DOI: 10.1177/02692155231152970] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To (1) reflect on challenges to the practice of person-centred rehabilitation; and (2) propose opportunities for the development of person-centred rehabilitation. CHALLENGES Person-centred practice has received widespread endorsement across healthcare settings and is understood to be an important, positive approach in rehabilitation. However, the rhetoric of this approach does not always translate meaningfully into practice. Emphasis on patient choice, patient involvement in decision making, and increasing patient capacity for self-management have become a proxy for person-centred rehabilitation in lieu of a more fundamental shift in practice and healthcare structures. System (e.g. biomedical orientation), organisational (e.g. key performance indicators) and professional (e.g. identity as expert) factors compete with person-centred rehabilitation. OPPORTUNITIES Four key recommendations for the development of person-centred rehabilitation are proposed including to: (1) develop a principles-based approach to person-centred rehabilitation; (2) move away from the dichotomy of person-centred (or not) rehabilitation; (3) build person-centred cultures of care in rehabilitation; and (4) learn from diverse perspectives of person-centred rehabilitation. CONCLUSION Fixed assumptions about what constitutes person-centred rehabilitation may limit our ability to respond to the needs of persons and families. Embedding person-centred ways of working is challenging due to the competing drivers and interests of healthcare systems and organisations. A principles-based approach, enabled by person-centred cultures of care, may achieve the aspirations of person-centred rehabilitation.
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Affiliation(s)
- Nicola M Kayes
- Faculty of Health and Environmental Sciences, Centre for Person Centred Research, School of Clinical Sciences, 1410Auckland University of Technology, Auckland, New Zealand
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Bellon M, Kelley J, Fisher A. "The bucket of gold at the end of the rainbow": personal experiences of hope after acquired brain injury. Disabil Rehabil 2022; 44:7974-7984. [PMID: 34813389 DOI: 10.1080/09638288.2021.2005162] [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: 01/18/2023]
Abstract
PURPOSE To investigate personal experiences of, and factors influencing hope following Acquired Brain Injury (ABI). METHODS A qualitative phenomenological approach was adopted consisting of semi-structured interviews with 15 adults with ABI. Interviews were transcribed and analysed using thematic analysis, and the Social Ecological Model (SEM) applied as a guiding framework to discuss findings and implications for policy and practice. RESULTS Five themes emerged: the importance of hope, changes in hope over time, the connection between hope and positivity, factors influencing hope and the importance of fostering hope. Participants reported varying experiences, with increased levels of hope influenced by: faith; supportive networks and professionals; goals; experiencing progress; having something to look forward to; and seeing others achieve. Professional attitudes were reported to either foster or negatively impact hope after brain injury. CONCLUSIONS These findings suggest that hope can play an important and often essential role in the lives of people with ABI. Factors influencing experiences of hope are organised against a SEM framework, identifying intrapersonal, interpersonal, institutional, community, and state and national implications for policy, professional practice and research.Implications for rehabilitationHope plays a critical role in the lives of people following acquired brain injury.Factors which positively influence hope include faith, supportive networks, goals, experiencing progress, and having something to look forward to.Professionals can impact an individual's experience of hope through person-centred and supportive therapeutic relationships.
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Affiliation(s)
- Michelle Bellon
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jasmin Kelley
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alinka Fisher
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Kenah K, Bernhardt J, Spratt NJ, Oldmeadow C, Janssen H. Depression and a lack of socialization are associated with high levels of boredom during stroke rehabilitation: An exploratory study using a new conceptual framework. Neuropsychol Rehabil 2022; 33:497-527. [PMID: 35142257 DOI: 10.1080/09602011.2022.2030761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This exploratory sub-study aimed to develop a framework to conceptualize boredom in stroke survivors during inpatient rehabilitation, establish the effect of an activity promotion intervention on boredom, and to investigate factors that are associated with boredom. A framework was developed and explored within a cluster non-randomised controlled trial. Self-reported boredom was measured in 160 stroke survivors 13 (±5) days after rehabilitation admission; 91 participants received usual-care (control) and 69 had access to a patient-driven model of activity promotion (intervention). Individuals with pre-existing dementia or unable to participate in standard rehabilitation were excluded. Hierarchical logistic regression analysis was used to identify demographic, health and activity measures associated with boredom. Results indicated 39% of participants were highly bored. There was no statistically significant difference in boredom levels between treatment groups (difference -11%, 95% CI -26% to 4%). The presence of depression (OR 6.17, 95% CI 2.57-14.79) and lower levels of socialization (OR 0.96, 95% CI 0.92-0.99) predicted high boredom levels. This comprehensive framework provides a foundation for understanding the many interacting factors associated with boredom. Results suggest managing depression and improving opportunities for socialization may support meaningful engagement in rehabilitation to optimize recovery following stroke.
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Affiliation(s)
- Katrina Kenah
- School of Health Sciences, The University of Newcastle, Newcastle, Australia.,Monash Health, Cheltenham, Australia
| | - Julie Bernhardt
- The Florey Institute of Neuroscience and Mental Health, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, Australia
| | - Neil J Spratt
- Hunter Medical Research Institute, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, The University of Newcastle, Newcastle, Australia.,Department Neurology, John Hunter Hospital, Newcastle, Australia
| | | | - Heidi Janssen
- Hunter Medical Research Institute, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, The University of Newcastle, Newcastle, Australia.,Hunter Stroke Service, Hunter New England Local Health District, Newcastle, Australia
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Fong TCT, Lo TLT, Ho RTH. Indirect effects of social support and hope on quality of life via emotional distress among stroke survivors: A three-wave structural equation model. Front Psychiatry 2022; 13:919078. [PMID: 35966472 PMCID: PMC9365992 DOI: 10.3389/fpsyt.2022.919078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Stroke survivors are prone to functional impairments and reduced quality of life (QoL). This study examined the mediating role of social support and hope in the relationships between functional impairment, emotional distress, and QoL. METHODS A total of 188 stroke survivors in Hong Kong completed assessments on functional impairment, social support, and hope at baseline, with follow-up measurements of emotional distress at 2 months and QoL at 8 months. Structural equation modeling with bootstrapping was used to analyze the direct and indirect effects of functional impairment on emotional distress and QoL via the mediating factors of social support and hope. RESULTS The partial cascading model provided an adequate fit to the data. Functional impairment had significant negative direct effects on hope and physical QoL and social support had significant positive direct effects on hope and physical QoL. Social support had a significant positive indirect effect on physical QoL via hope and perceived stress and on psychosocial QoL via hope and depression. Functional impairment and hope had a significant negative interaction effect on perceived stress. CONCLUSION The findings support a mediating role for hope in the relationship between social support and QoL in stroke survivors. The protective effect of hope on perceived stress was stronger among patients with greater functional impairment.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Temmy L T Lo
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rainbow T H Ho
- Centre on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Abstract
Abstract
Background and Aims:
Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons’ ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation.
Design and Methods:
This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions.
Findings:
Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating.
Conclusions:
Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity – highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.
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Cheng BBY, Ryan B, Copland DA, Wallace SJ. Prognostication in post-stroke aphasia: speech pathologists' clinical insights on formulating and delivering information about recovery. Disabil Rehabil 2021; 44:5046-5059. [PMID: 33969776 DOI: 10.1080/09638288.2021.1922514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE For people with post-stroke aphasia, "Will I get better?" is a question often asked, but one that is intellectually and emotionally demanding for speech pathologists to answer. Speech pathologists' formulation and delivery of aphasia prognoses is varied and there is limited evidence for optimising practice. We aimed to understand speech pathologists' clinical experiences, reasoning, and support needs in aphasia prognostication. MATERIALS AND METHODS Twenty-five Australian speech pathologists working with people with aphasia participated in individual, semi-structured interviews. Their age, level of experience, work setting, and location were maximally varied. Interview responses were analysed qualitatively using thematic analysis. RESULTS Five themes were drawn from the interviews: (1) prognostic challenges are shared but not voiced; (2) truth is there's no quick fix; (3) recovery is more than words; (4) the power of words; and, (5) prognostic competence is implicit. CONCLUSIONS Speech pathologists use implicit competencies to formulate and deliver aphasia prognoses. A patient-centred, holistic contextualisation of aphasia recovery may enable realistic, optimistic, and constructive conversations about prognosis. These conversations may have therapeutic potential if prognostic uncertainty, emotional adjustment, and conditional outcomes are carefully addressed. Future research should seek to understand the perceptions and preferences of people with aphasia and their significant others.Implications for RehabilitationAphasia prognostication in clinical practice is complex and nuanced, thus increased clinical and research focus is warranted to ensure key stakeholder needs are met.Conversations about prognosis may be more meaningful to people with aphasia if recovery is conceptualised as encompassing impairment, activity, and participation outcomes.Given the implicit competencies required for prognostication, a structured approach to reflective practice and experience-based training may be beneficial.Conversations about prognosis may have therapeutic value, but further research is needed to explore this potential.
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Affiliation(s)
- Bonnie B Y Cheng
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Brooke Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia.,Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - David A Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia.,University of Queensland Centre for Clinical Research, Herston, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
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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
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Understanding people’s experiences of using the SaeboFlex® following a stroke. Br J Occup Ther 2020. [DOI: 10.1177/0308022620943781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction This qualitative interpretive phenomenological study sought to understand the experiences of people using the SaeboFlex®, within an outpatient setting, following a stroke. Method Five adults who had experienced a stroke and had received the SaeboFlex® from occupational therapists in one outpatient service within the previous 12 months were recruited using convenience sampling. Semi-structured interviews were conducted, recorded, transcribed verbatim, and analysed using Braun and Clarke’s thematic analysis. Results Three themes emerged from the data: (a) hope for upper limb recovery: ‘you have got nothing to lose’; (b) the everyday experience of the SaeboFlex®: ‘just keeping it in a routine’; (c) the self-reported outcomes: ‘I can do more things you know … but there haven’t been any miracles’. Conclusion The findings highlight the important role of hope in the recovery of people following a stroke, and that participants continue to use the device despite limited goal achievement. The reports of limited transfer of training into everyday occupations, either with or without the device, is something that should be carefully considered. The SaeboFlex® is a tool that is promoted for upper limb rehabilitation, but which has limited evidence of effectiveness and mixed client experiences. Further research is required.
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Katsimigos AM, O'Beirne S, Harmon D. Hope and chronic pain-a systematic review. Ir J Med Sci 2020; 190:307-312. [PMID: 32451764 DOI: 10.1007/s11845-020-02251-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hope is considered as an important therapeutic factor in health and illness. Chronic pain affects a significant proportion of the world's population and causes great emotional and physical suffering to patients. OBJECTIVE The aim of this systematic review is to explore the current literature on hope and chronic pain. METHODS A comprehensive review of current literature on hope and chronic pain was undertaken. Several databases were used (incorporating EBSCO, MEDLINE, PUBMED). Search terms included 'hope' and 'hopelessness' in conjunction with 'chronic pain, 'pain management' and 'pain reduction'. Articles were included if they reported a study (1) exploring outcomes of hope as an intervention for chronic pain, (2) reported on hope specifically and not related concepts and (3) included a measurement of hope. RESULTS A total of three articles were found which fit the inclusion criteria. Each article used different tools to measure hope. The review demonstrates a gap in the literature regarding hope as a therapeutic intervention for chronic pain specifically. CONCLUSIONS The findings of this review demonstrate that hope is influenced by several patient factors and has a positive impact on patients with chronic pain. The current literature supports the usefulness of hope as a therapeutic intervention for not only chronic pain but many chronic illnesses.
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Affiliation(s)
| | - Sheena O'Beirne
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Dominic Harmon
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland. .,Department of Anesthesia and Pain Medicine, Limerick University Hospital, Dooradoyle, Limerick, Ireland.
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Pereira CM, Greenwood N, Jones F. From recovery to regaining control of life - the perspectives of people with stroke, their carers and health professionals. Disabil Rehabil 2020; 43:2897-2908. [PMID: 32036730 DOI: 10.1080/09638288.2020.1722263] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: To understand how people with stroke and carers adapt over time, and how health professionals support transition to home.Method: A multi-perspective, prospective, qualitative, longitudinal study was conducted using in-depth semi-structured interviews one and six months after inpatient discharge. Twenty-four participants (eight triads, including people with stroke, carers and health professionals) were included. Thematic and narrative analysis facilitated identification of cross-cutting themes according to individual trajectories post-stroke.Findings: A major theme: "regaining control of life" suggested a shift in perspective after six months at home. Four sub-themes help to understand the triads' perspectives over time: i) importance of team involvement; ii) differences in perceived roles within the triad; iii) differences in expectations and collaboration within the triad and iv) planning a different future. People who were involved in supporting adaptation and rehabilitation processes were reported differently between triads and over time, showing the complexity of interrelations. A reduction in professional involvement was matched by changes in participants' goals and expectations.Conclusion: Findings suggest the importance of a dyadic perspective and a gradual increase in people with stroke and carers' active engagement. Professionals' approach throughout rehabilitation should be modified according to people with stroke and carers' changing needs and expectations.IMPLICATIONS FOR REHABILITATIONDivergence in perspectives about priorities and goals between the person with stroke their carers and healthcare professionals can lead to the creation of different agendas within rehabilitation.An open dialogue and decision-making process that involves both the person with stroke and carers is highly recommended for the identification of shared rehabilitation goals and to support ongoing recovery post discharge.A tailored approach to rehabilitation is required which focusses on shared priorities and includes individual or collective support for the person with stroke and their carers.Ongoing consultation about the desires of the person with stroke about rehabilitation, priorities and goals is important in order to tailor the professional approach to the stage individuals are at with their coping and adjustment post stroke.
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Affiliation(s)
- Carla Mendes Pereira
- Department of Physiotherapy, School of Health Care, Setubal Polytechnic Institute, Setúbal, Portugal
| | - Nan Greenwood
- Faculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK
| | - Fiona Jones
- Faculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK
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Psychometric Properties of the Korean Dispositional Hope Scale Using the Rasch Analysis in Stroke Patients. Occup Ther Int 2019; 2019:7058415. [PMID: 31819741 PMCID: PMC6885203 DOI: 10.1155/2019/7058415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background It is reported that hopeful thinking plays a positive role in encouraging patients to achieve functional goals during the rehabilitation process. Hope is a key concept in evaluating stroke outcomes in research and rehabilitation practice. Aims The purpose of this study was to investigate the psychometric properties of the Korean Dispositional Hope Scale (K-DHS) using the Rasch analysis in patients with hemiplegic stroke. Methods The K-DHS was completed by 166 community-dwelling hemiplegic stroke patients in Korea. Data were analyzed according to item fit, item difficulty, and the appropriateness of the rating scale using the Rasch analysis. Results Item fit analysis showed that 8 items of the K-DHS are appropriate because the infit MSNQ was between 0.7 and 1.3. Item difficulty results revealed that there is a difference in distribution between personal attributes and item difficulty. It shows that the item fit statistics of the 4-point Likert scale of K-DHS are all good. The person separation index demonstrated that the K-DHS could differentiate two or three hope status strata in stroke patients. The item separation index indicated that the items were useful with high reliability. Conclusion The K-DHS comprises appropriate items for measuring the hope of stroke patients living in the community, and the rating scale of the K-DHS is also appropriate. This study is the first to conduct an analysis of the rating scale and its appropriateness, as well as the difficulty of items based on item response theory, and offers new insights for enhancing hope and improving well-being following stroke.
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Bright FAS, McCann CM, Kayes NM. Recalibrating hope: A longitudinal study of the experiences of people with aphasia after stroke. Scand J Caring Sci 2019; 34:428-435. [PMID: 31487069 PMCID: PMC7432176 DOI: 10.1111/scs.12745] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022]
Abstract
Background Hope is a critical resource for people with aphasia after stroke, sustaining people though times of distress and uncertainty and providing motivation. In the first months after stroke, hope is vulnerable to different influences, and people can struggle to identify and work towards hopes for the future. We have little knowledge about how people with aphasia experience hope in the longer term after stroke. Objectives To identify how people with aphasia experience hope 1 year after stroke and how hope may change in the year after stroke. Methods The study used an Interpretive Description methodology. Interviews were conducted with four people with aphasia who had been interviewed 1 year previously. These were analysed using content analysis. Results All people reported a broad sense of hope for the future. They described an active process of recalibrating their early poststroke hopes through a process of reflecting on past progress, current function and what they considered might be possible and desirable in the future. People were able to develop ‘new’ hopes that were meaningful and seemingly achievable when they had a sense of a possible, desirable future. Those who struggled to see a possible future maintained a hope that things will be good. Social supports, a sense of progress, engagement in meaningful activities and interactions appeared crucial in helping people (re)develop hopes for their future. Conclusions Hope and hopes for the future gradually changed after stroke. Hope, identity and social connectedness were closely entwined and could enable people to both dwell in the present and move towards desired futures. This research suggests clinicians should prioritise creating hope‐fostering environments which support people to develop hope for their future.
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Affiliation(s)
- Felicity A S Bright
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Clare M McCann
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Nicola M Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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17
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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.
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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
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Suddick KM, Cross V, Vuoskoski P, Stew G, Galvin KT. The acute stroke unit as a meaningful space: The lived experience of healthcare practitioners. Health Place 2019; 57:12-21. [PMID: 30849691 DOI: 10.1016/j.healthplace.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/08/2018] [Accepted: 02/07/2019] [Indexed: 11/17/2022]
Abstract
This hermeneutic phenomenological study was undertaken in response to the recent re-organization of stroke unit provision in the United Kingdom. Through the analysis of four acute stroke unit practitioners' subjective accounts, the acute stroke unit emerged as a dynamic, meaningful space, where they experienced authenticity and belonging. The findings showed how these practitioners navigated their way through the space, thriving, and/or surviving its' associated vulnerabilities. They offer a different gaze on which to attend to the complexity and challenge that is interwoven with health professionals' flourishing, the spatiality of healthcare practice, and perhaps other demanding places of work.
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Affiliation(s)
- Kitty Maria Suddick
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Vinette Cross
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom
| | - Pirjo Vuoskoski
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Graham Stew
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Kathleen T Galvin
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
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Kulnik ST, Mohapatra S, Gawned S, Jones F. Managing the severely impaired arm after stroke: a mixed-methods study with qualitative emphasis. Disabil Rehabil 2018; 42:1826-1834. [DOI: 10.1080/09638288.2018.1539777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Stefan Tino Kulnik
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, UK
| | - Sushmita Mohapatra
- Therapy Services, King’s College Hospital NHS Foundation Trust, London, UK
| | - Sara Gawned
- Therapies Department, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Fiona Jones
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, UK
- Bridges Self-Management Limited, London, UK
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20
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Kersten P, Cummins C, Kayes N, Babbage D, Elder H, Foster A, Weatherall M, Siegert RJ, Smith G, McPherson K. Making sense of recovery after traumatic brain injury through a peer mentoring intervention: a qualitative exploration. BMJ Open 2018; 8:e020672. [PMID: 30309988 PMCID: PMC6252636 DOI: 10.1136/bmjopen-2017-020672] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 06/16/2018] [Accepted: 08/21/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore the acceptability of peer mentoring for people with a traumatic brain injury (TBI) in New Zealand. DESIGN This is a qualitative descriptive study exploring the experiences reported by mentees and mentors taking part in a feasibility study of peer mentoring. Interviews with five mentees and six mentors were carried out. Data were analysed using conventional content analysis. SETTING The first mentoring session took place predischarge from the rehabilitation unit. The remaining five sessions took place in mentees' homes or community as preferred. PARTICIPANTS Twelve people with TBI took part: six mentees (with moderate to severe TBI; aged 18-46) paired with six mentors (moderate to severe TBI >12 months previously; aged 21-59). Pairing occurred before mentee discharge from postacute inpatient brain injury rehabilitation. Mentors had been discharged from rehabilitation following a TBI between 1 and 5 years previously. INTERVENTION The peer mentoring programme consisted of up to six face-to-face sessions between a mentee and a mentor over a 6-month period. The sessions focused on building rapport, exploring hopes for and supporting participation after discharge through further meetings and supported community activities. RESULTS Data were synthesised into one overarching theme: making sense of recovery. This occurred through the sharing of experiences and stories; was pivotal to the mentoring relationship; and appeared to benefit both mentees and mentors. Mentors were perceived as valued experts because of their personal experience of injury and recovery, and could provide support in ways that were different from that provided by clinicians or family members. Mentors required support to manage the uncertainties inherent in the role. CONCLUSIONS The insight mentors developed through their own lived experience established them as a trusted and credible source of hope and support for people re-engaging in the community post-TBI. These findings indicate the potential for mentoring to result in positive outcomes.
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Affiliation(s)
- Paula Kersten
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Christine Cummins
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Duncan Babbage
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Centre for eHealth, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Hinemoa Elder
- Te Whare Wānanga o Awanuiārangi, Auckland, New Zealand
| | | | - Mark Weatherall
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | - Richard John Siegert
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Greta Smith
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Kathryn McPherson
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Health Research Council of New Zealand, Auckland, New Zealand
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Redlich-Amirav D, Ansell LJ, Harrison M, Norrena KL, Armijo-Olivo S. Psychometric properties of Hope Scales: A systematic review. Int J Clin Pract 2018; 72:e13213. [PMID: 29920883 DOI: 10.1111/ijcp.13213] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 05/01/2018] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Hope is recognised as an important factor in health, illness, and well-being. Many scales to measure hope have been developed and used in various disciplines, yet, their psychometric properties have not been systematically reviewed. AIM To systematically review the psychometric properties of hope scales. DESIGN Systematic review. METHODS Four electronic databases were searched followed by a hand search. The data were extracted and qualitatively evaluated by the COSMIN checklist, an instrument designed as a quality rating tool for systematic reviews of psychometric properties. RESULTS From 1271 retrieved abstracts, 68 papers met the inclusion criteria. The most used scale was the Snyder Hope Scale (46%) followed by the Herth Hope Index (16%). All other scales (n = 16) were evaluated in less than 10% of the papers. Structural validity (91%), internal consistency (88%), and hypothesis testing (74%) were the most reported properties. Reliability (34%), cross-cultural validity (34%), content validity (25%), and criterion validity (15%) were reported in less than 50% of the papers. Only two (3%) studies reported responsiveness, and none reported measurement error. Less than 35% of the validation studies achieved excellent or good quality for any of the measurement properties. CONCLUSION The results show that no robust and valid scale exists for measuring hope. It highlights important gaps in psychometric properties of hope scales. Despite more than 40 years of research and development of hope scales, the currently available scales do not meet the standards of psychometric evaluation. This calls for efforts to improve the quality of hope scales.
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Affiliation(s)
- Dorit Redlich-Amirav
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, School of Health Professions Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Levi J Ansell
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | | | | | - Susan Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Institute of Health Economics, Edmonton, AB, Canada
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Lawton M, Sage K, Haddock G, Conroy P, Serrant L. Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:550-563. [PMID: 29349881 PMCID: PMC5969294 DOI: 10.1111/1460-6984.12368] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 05/13/2023]
Abstract
BACKGROUND Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. AIMS To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. METHODS & PROCEDURES Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. OUTCOMES & RESULTS Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. CONCLUSIONS & IMPLICATIONS The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in goal setting, relational strategies; and motivational enhancement techniques. The conceptualization of therapeutic alliance, however, is only provisional. Further research is essential to elucidate the experiences and perceptions of alliance development for people with aphasia undergoing rehabilitation.
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Affiliation(s)
- Michelle Lawton
- Department of Psychological SciencesUniversity of ManchesterManchesterUK
| | - Karen Sage
- Faculty of Health and WellbeingSheffield Hallam UniversitySheffieldUK
| | - Gillian Haddock
- Department of Psychological SciencesUniversity of ManchesterManchesterUK
| | - Paul Conroy
- Department of Psychological SciencesUniversity of ManchesterManchesterUK
| | - Laura Serrant
- Faculty of Health and WellbeingSheffield Hallam UniversitySheffieldUK
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Fisher A, Bellon M, Lawn S, Lennon S, Sohlberg M. Family-directed approach to brain injury (FAB) model: a preliminary framework to guide family-directed intervention for individuals with brain injury. Disabil Rehabil 2017; 41:854-860. [PMID: 29171308 DOI: 10.1080/09638288.2017.1407966] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This article proposes a theoretical framework to help professionals include family as active members in brain injury rehabilitation. A trend towards greater family involvement has lead to the development of family-collaboration models. However, current models appear to focus on information sharing rather than increasing the capability of family members. This article introduces a family-directed approach to brain injury model, which provides a theoretical framework for supporting family as facilitators of change. METHODS Family-collaboration models and literature regarding family experiences following brain injury and support needs are reviewed to identify the driving forces behind family engagement in rehabilitation, including effective professional-family relationships, and important factors in the delivery of education underpinned by evidence-based practices. RESULTS The family-directed approach to brain injury model is based on principles of hope, family expertise, education/skill building, and family-directed intervention. CONCLUSIONS The family-directed approach to brain injury model provides a theoretical framework for educating and training family members as facilitators in the management process: promoting competence rather than dependency on service systems. Guiding recommendations encourage professionals to reflect on the importance of their therapeutic relationships and their capacity to positively impact rehabilitation outcomes beyond the technical aspects of health care and treatment. Implications for Rehabilitation Training family members as facilitators in the rehabilitation process is suggested to reduce dependency on the service system, address families' unmet support needs, and to optimize rehabilitation outcomes for individuals with brain injury. The family-directed approach to brain injury model is proposed to guide the increased involvement of family as active members in the rehabilitation team and to define potential active ingredients in this process.
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Affiliation(s)
- Alinka Fisher
- a Disability and Community Inclusion, College of Nursing and Health Sciences , Flinders University , Adelaide , Australia
| | - Michelle Bellon
- a Disability and Community Inclusion, College of Nursing and Health Sciences , Flinders University , Adelaide , Australia
| | - Sharon Lawn
- b Department of Psychiatry , Flinders University , Adelaide , Australia
| | - Sheila Lennon
- c Discipline of Physiotherapy , Flinders University , Adelaide , Australia
| | - McKay Sohlberg
- d Communication Disorders & Sciences , University of Oregon , Eugene, OR, USA
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Park EY, Kim JH. The factor structure of the Dispositional Hope Scale in hemiplegic stroke patients. J Ment Health 2017; 26:556-561. [PMID: 28994346 DOI: 10.1080/09638237.2017.1385735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Hope is an important coping strategy and psychological resource for patients with a chronic illness. Stroke patients are exposed to stressful situations such as limited daily life activities, cognitive impairments and financial burdens. AIM This study investigated the factor structure of the Dispositional Hope Scale (DHS) and verified its validity when examining stroke patients. METHODS This methodological study used secondary, cross-sectional data analysis to investigate the factors related to participation restriction in chronic stroke patients. The DHS's reliability was assessed by calculating the internal consistency of Cronbach's α. The structure of the DHS was analyzed by confirmatory factor analysis. The one-factor model (Korean version), two-factor model (original version) and bifactor models were compared. RESULTS The fit indices provided evidence for the two-factor DHS model among hemiplegic stroke patients. Although the two-factor model was identified as superior by the Akaike information criterion value, both models had strong goodness-of-fit indices. The DHS had an adequate level of internal consistency in measuring hope in stroke patients. CONCLUSIONS The DHS is a valid, reliable and useful tool for examining hemiplegic stroke patients. Identifying the psychometric properties of the DHS can help health professionals implement program development for stroke patients.
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Affiliation(s)
- Eun-Young Park
- a Department of Secondary Special Education , College of Education, Jeonju University , Jeonju , Korea and
| | - Jung-Hee Kim
- b Department of Clinical Nursing, College of Nursing , The Catholic University of Korea , Seoul , Korea
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Liang P, Fleming J, Gustafsson L, Griffin J, Liddle J. Family members' experiences of driving disruption after acquired brain injury. Brain Inj 2017; 31:517-525. [PMID: 28340304 DOI: 10.1080/02699052.2017.1283058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE 1) To explore family members' lived experiences of driving disruption at early and later stages of the recovery continuum following acquired brain injury (ABI). 2) To describe health-related quality of life of family members of individuals with ABI who are experiencing driving disruption. RESEARCH DESIGN Mixed methods phenomenological research approach. METHODS AND PROCEDURES Semi-structured interviews and health-related quality of life questionnaires were conducted with 15 family members of individuals with ABI (early group: 1-12 months post-injury, n = 6; later group: >1 year post-injury, n = 9). RESULTS Two main themes were identified: Different for everyone: how driving disruption affects families, and Making it harder: context of driving disruption. The challenges of driving disruption were reported more frequently and with a more intense focus by family members who were caring for their relative for more than 1 year post-injury. This group also reported higher caregiver strain and poorer health-related quality of life. Reduced satisfaction with life, poor mental health and affected family functioning were reported by both groups. CONCLUSIONS Driving disruption impacts on family members and has long-lasting consequences. It is important for clinicians to work with family members to manage these challenges even years after ABI and consider individual contextual factors.
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Affiliation(s)
- Phyllis Liang
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia
| | - Jennifer Fleming
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia.,b Department of Occupational Therapy , Princess Alexandra Hospital , Brisbane , Queensland , Australia
| | - Louise Gustafsson
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia
| | - Janelle Griffin
- b Department of Occupational Therapy , Princess Alexandra Hospital , Brisbane , Queensland , Australia
| | - Jacki Liddle
- c UQ Centre for Clinical Research , The University of Queensland , Brisbane , Queensland , Australia
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Liang P, Gustafsson L, Liddle J, Fleming J. Family members' needs and experiences of driving disruption over time following an acquired brain injury: an evolving issue. Disabil Rehabil 2016; 39:1398-1407. [PMID: 27347745 DOI: 10.1080/09638288.2016.1196397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Family members often assume the role of driver for individuals who are not driving post-acquired brain injury (ABI). Given that return to driving can be unpredictable and uncertain, the impact of driving disruption on family members may vary at different stages post-injury. This study aims to understand the needs and experiences of family members over time during driving disruption following an ABI. METHOD A qualitative prospective longitudinal research design was used with semi-structured interviews at recruitment to study, 3 and 6 months later. RESULTS Fourteen family members completed 41 interviews. The longitudinal data revealed four phases of driving disruption: (1) Wait and see, (2) Holding onto a quick fix, (3) No way out, and (4) Resolution and adjustment. The phases described a process of building tension and a need for support and resolution over time. CONCLUSIONS Holding onto a quick fix is a pivotal phase whereby supports, such as engagement in realistic goal setting, are essential to facilitate family members' resolution of driving disruption issues. Family members who see no way out might not actively seek help and these points to a need for long-term and regular follow-ups. Future research can explore ways to support family members at these key times. Implications for rehabilitation Health professionals need to facilitate the process of fostering hope in family members to set realistic expectations of return to driving and the duration of driving disruption. It is necessary to follow-up with family members even years after ABI as the issue of driving disruption could escalate to be a crisis and family members might not actively seek help. Health professionals can consider both practical support for facilitating transport and emotional support when addressing the issue of driving disruption with family members.
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Affiliation(s)
- Phyllis Liang
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia
| | - Louise Gustafsson
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia
| | - Jacki Liddle
- b Queensland Brain Institute, The University of Queensland , Brisbane , Queensland , Australia
| | - Jennifer Fleming
- a Division of Occupational Therapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Queensland , Australia.,c Occupational Therapy Department , Princess Alexandra Hospital , Brisbane , Queensland , Australia
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Walsh ME, Galvin R, Loughnane C, Macey C, Horgan NF. Community re-integration and long-term need in the first five years after stroke: results from a national survey. Disabil Rehabil 2016; 37:1834-8. [PMID: 25391817 DOI: 10.3109/09638288.2014.981302] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Acute stroke care continues to improve but the later stroke recovery phase remains less well understood. The aim of this study was to document self-reported need in relation to stroke recovery and community re-integration among community-dwelling persons up to five years post-stroke. METHODS A national survey was carried out in Ireland. Participants were recruited through stroke advocacy organisations and health professionals. Existing validated questionnaires were adapted with permission. The final questionnaire assessed respondents' perceptions of their community re-integration and on-going needs. RESULTS A total of 196 stroke survivors, aged 24-89 years responded. Over 75% of respondents reported experiencing mobility, emotional, fatigue and concentration difficulties post-stroke. Emotional problems and fatigue demonstrated the highest levels of unmet need. Families provided much support with 52% of people needing help with personal care post-stroke. Forty-two per cent of respondents in a relationship felt that it was significantly affected by their stroke. In addition, 60% of respondents reported negative financial change. Only 23% of those <66 years had worked since their stroke, while 60% of drivers returned to driving. CONCLUSIONS Stroke had a personal, social and economic impact. Emotional distress and fatigue were common and satisfaction with the help available for these problems was poor. Implications for Rehabilitation Professionals should recognise that family members provide high levels of support post-stroke while dealing with changes to personal relationships. Emotional, concentration and fatigue problems post-stroke require recognition by health professionals. A greater focus on return-to-work as part of stroke rehabilitation may be of value for patients of working age.
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Affiliation(s)
- Mary Elizabeth Walsh
- a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland
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Haugan G, Moksnes UK, Løhre A. Intrapersonal self-transcendence, meaning-in-life and nurse-patient interaction: powerful assets for quality of life in cognitively intact nursing-home patients. Scand J Caring Sci 2016; 30:790-801. [DOI: 10.1111/scs.12307] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/08/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing Science; Center for Health Promotion Research; HIST; Sør-Trøndelag University College; Trondheim Norway
| | - Unni Karin Moksnes
- Faculty of Nursing Science; Center for Health Promotion Research; HIST; Sør-Trøndelag University College; Trondheim Norway
| | - Audhild Løhre
- Center for Health Promotion Research; Faculty of Teaching and Sign Language Interpretation; HiST, Sør-Trøndelag University College; Trondheim Norway
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Malički M, Marković D, Marušić M. Association of trait and specific hopes: cross sectional study on students and workers of health professions in Split, Croatia. PeerJ 2016; 4:e1604. [PMID: 26819851 PMCID: PMC4727959 DOI: 10.7717/peerj.1604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/25/2015] [Indexed: 11/20/2022] Open
Abstract
Introduction. Hope (hoping) is most commonly assessed as a dispositional trait and associated with quality of life, self-care agency and non-attempts of suicide. However, little research has been conducted on hoping for specific events. Materials and Methods. We distributed a survey consisting of Integrative Hope Scale (IHS) and visual analogue scales on which respondents could declare their levels (intensity) of hope for specific events, to all first year health students enrolled at the University Department of Health Studies, Split, Croatia in 2011/2012, as well as to working health professionals attending a nursing conference in April 2012. Results. A total of 161 (89.4%) students and 88 (89.8%) working health professionals returned the completed questionnaires. We found high trait hope scores of students and working health professionals (Md = 111, 95% CI [109–113] vs. Md = 115, 95% CI [112–119]; U = 5,353, P = 0.065), and weak to moderate correlations of trait and specific hopes (r = 0.18–0.48, Spearman’s rank correlation coefficient). Students and workers reported 31 different things they hoped for most in life, of which the most prevalent were being healthy and happy. There was very little agreement between participants’ reported influence of the four factors compromising the trait hope (self-confidence, ambition, optimism, and social support) on their specific hopes. Conclusions. Our findings, while strengthening the validity of hope as a trait, indicate that specific hopes of individuals are moderated by factors not captured by the IHS trait scale. Further research should explore specific hoping in detail, as well as the effectiveness of interventions aimed at increasing specific or generalized hoping.
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Affiliation(s)
- Mario Malički
- School of Medicine, Department of Research in Biomedicine and Health, University of Split, Split , Croatia
| | - Domagoj Marković
- School of Medicine, Department of Research in Biomedicine and Health, University of Split, Split , Croatia
| | - Matko Marušić
- School of Medicine, Department of Research in Biomedicine and Health, University of Split, Split , Croatia
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Nordin Å, Sunnerhagen KS, Axelsson ÅB. Patients' expectations of coming home with Very Early Supported Discharge and home rehabilitation after stroke - an interview study. BMC Neurol 2015; 15:235. [PMID: 26572860 PMCID: PMC4647613 DOI: 10.1186/s12883-015-0492-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An Early Supported Discharge (ESD) and rehabilitation from a coordinated team in the home environment is recommended in several high-income countries for patients with mild to moderate symptoms after stroke. Returning home from the hospital takes place very early in Sweden today (12 days post stroke), thus the term Very Early Supported Discharge (VESD) is used in the current study. The aim of this study was to describe patients' expectations of coming home very early after stroke with support and rehabilitations at home. METHOD This is an interview study nested within a randomized controlled trial; Gothenburg Very Early Supported Discharge (GOTVED), comparing VESD containing a home rehabilitation intervention from a coordinated team to conventional care after stroke. Ten participants (median age 69) with mild to moderate stroke symptoms (NHISS 0 to 8 points) were recruited from the intervention group in GOTVED. Interviews were conducted 0-5 days before discharge and the material was analyzed with qualitative content analysis. RESULTS Four main categories containing 11 subcategories were found. The VESD team was expected to provide "Support towards independency", by helping the participants to manage and feel safe at home as well as to regain earlier abilities. The very early discharge gave rise to expectations of coming home to "A new and unknown situation", causing worries not to manage at home and to leave the safe environment at the ward. A fear to suffer a recurrent stroke when being out of reach of immediate professional help was also pronounced. In contrast to these feelings of insecurity and fear, "Returning to one's own setting" described the participants longing home, where they would become autonomous and capable people again. They expected this to facilitate recovery and rehabilitation. "A new everyday life" waited for the participants at home and this was expected to be challenging. Different strategies to deal with these challenges were described. CONCLUSIONS The participants described mixed expectations such as insecurity and fear, and on the other hand, longing to come home. Moreover, they had a high degree of confidence in the expected support of the VESD team. The health professionals at the hospital may build on this trust to reduce the patients' insecurity for coming home. In addition, it may be beneficial to explore the patients' expectations thoroughly in front of discharge, as certain feelings and thoughts could complicate or support the home coming process. Thus, a greater attention on such expectations may facilitate the patient's transition from hospital to home after stroke.
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Affiliation(s)
- Åsa Nordin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Sunnaas Rehabilitation Hospital, Nesodden, Oslo, Norway.
| | - Åsa B Axelsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Female Spouses’ Perceptions of the Sexual Relationship with Stroke-Affected Partners. SEXUALITY AND DISABILITY 2015. [DOI: 10.1007/s11195-015-9404-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saywell N, Taylor D. Focus group insights assist trial design for stroke telerehabilitation: a qualitative study. Physiother Theory Pract 2014; 31:160-5. [PMID: 25404160 DOI: 10.3109/09593985.2014.982234] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of the study was to draw on the insights of people with stroke to assist in the development of a telerehabilitation program, using easily accessible technology to deliver an intervention. A qualitative study was conducted with four focus groups of people who were at least 12 months post-stroke and who had completed their rehabilitation. All focus groups were conducted in community facilities and used a semi-structured approach. Fifteen people took part in the focus groups. Three main themes emerged from the data in response to questions about use of technology and important aspects of physiotherapy. The first theme expressed the participants' perspective that the technology really helped with "keeping connected". The second theme indicated "what we need from therapists" in order to gain the most from therapy; and the third theme highlighted aspects of a physiotherapy program they considered important, "what we would like from therapy". The themes helped us gain insight into how participants viewed the use of technology to augment rehabilitation and also what they needed from therapists to make the gains they viewed as important. These themes informed the development of a telerehabilitation program using readily accessible technology.
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Affiliation(s)
- Nicola Saywell
- Health and Rehabilitation Research Institute, Auckland University of Technology , Northcote, Auckland , New Zealand
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Walsh ME, Galvin R, Loughnane C, Macey C, Horgan NF. Factors associated with community reintegration in the first year after stroke: a qualitative meta-synthesis. Disabil Rehabil 2014; 37:1599-608. [PMID: 25382215 DOI: 10.3109/09638288.2014.974834] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Although acute stroke care has improved survival, many individuals report dissatisfaction with community reintegration after stroke. The aim of this qualitative meta-synthesis was to examine the barriers and facilitators of community reintegration in the first year after stroke from the perspective of people with stroke. METHODS A systematic literature search was conducted. Papers that used qualitative methods to explore the experiences of individuals with stroke around community reintegration in the first year after stroke were included. Two reviewers independently assessed the methodological quality of papers. Themes, concepts and interpretations were extracted from each study, compared and meta-synthesised. RESULTS From the 18 included qualitative studies four themes related to community reintegration in the first year after stroke were identified: (i) the primary effects of stroke, (ii) personal factors, (iii) social factors and (iv) relationships with professionals. CONCLUSIONS This review suggests that an individual's perseverance, adaptability and ability to overcome emotional challenges can facilitate reintegration into the community despite persisting effects of their stroke. Appropriate support from family, friends, the broader community and healthcare professionals is important. Therapeutic activities should relate to meaningful activities and should be tailored to the individual stroke survivor. IMPLICATIONS FOR REHABILITATION Stroke survivors feel that rehabilitation in familiar environments and therapeutic activities that reflect real-life could help their community re-integration. In addition to the physical sequelae of stroke, emotional consequences of stroke should be addressed during rehabilitation. Healthcare professionals can provide clear and locally relevant advice to facilitate aspects of community reintegration, including the return to driving and work.
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Affiliation(s)
- Mary E Walsh
- School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland
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Bright FAS, Kayes NM, Worrall L, McPherson KM. A conceptual review of engagement in healthcare and rehabilitation. Disabil Rehabil 2014; 37:643-54. [DOI: 10.3109/09638288.2014.933899] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Soundy A, Stubbs B, Freeman P, Coffee P, Roskell C. Factors influencing patients' hope in stroke and spinal cord injury: A narrative review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.5.210] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Soundy
- Lecturer in Physiotherapy at the University of Birmingham
| | | | - Paul Freeman
- Lecturer in Sport Psychology at University of Exeter
| | - Pete Coffee
- Lecturer in Sports Psychology at the University of Stirling
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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.
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Brown M, Levack W, McPherson KM, Dean SG, Reed K, Weatherall M, Taylor WJ. Survival, momentum, and things that make me “me”: patients’ perceptions of goal setting after stroke. Disabil Rehabil 2013; 36:1020-6. [DOI: 10.3109/09638288.2013.825653] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Background: Nursing home care increasingly targets those elderly with the greatest needs in terms of personal daily activities, whereas services supporting spiritual needs such as hope tend to be ignored. Hope is seen to be a dynamic life force vital to well-being. Nursing home patients are frail, vulnerable, and dependent, which may lead to their hope being intimately related to the nurse–patient interaction. Purpose: The purpose of this study was to investigate the relationship between nurse–patient interaction and hope among cognitively intact nursing home patients. Design and method: Cross-sectional data were obtained by means of one-on-one interviews; 202 cognitively intact nursinghome patients representing 44 Norwegian nursing homes responded to the Herth Hope Index and the Nurse–Patient Interaction Scale. The hypothesized relationships between a two-factor construct of hope and nurse–patient interaction were assessed by means of structural equation modelling. Results: The structural equation model revealed a good fit to the data, showing significant influence of nurse–patient interaction on nursing home patients’ level of hope. Conclusion and implications: Nurse–patient interaction significantly influences hope in cognitively intact nursing home patients. Offering connectedness should be a central and integral aspect of holistic nursing home care. Providing continuing educational programs for caregivers focusing on how to interact with patients in a health-promoting and hopeful manner seems essential.
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Affiliation(s)
- Gørill Haugan
- Norwegian University of Science and Technology, Trondheim, Norway
- Sør-Trøndelag University College, Trondheim, Norway
- Research Centre in Health Promotion and Resources, Trondheim, Norway
| | - Unni Karin Moksnes
- Sør-Trøndelag University College, Trondheim, Norway
- Research Centre in Health Promotion and Resources, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
- Sør-Trøndelag University College, Trondheim, Norway
- Research Centre in Health Promotion and Resources, Trondheim, Norway
| | - Geir Arild Espnes
- Norwegian University of Science and Technology, Trondheim, Norway
- Sør-Trøndelag University College, Trondheim, Norway
- Research Centre in Health Promotion and Resources, Trondheim, Norway
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Mudge S, Stretton C, Kayes N. Are physiotherapists comfortable with person-centred practice? An autoethnographic insight. Disabil Rehabil 2013; 36:457-63. [DOI: 10.3109/09638288.2013.797515] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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40
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Haugan G, Utvær BKS, Moksnes UK. The Herth Hope Index—A Psychometric Study Among Cognitively Intact Nursing Home Patients. J Nurs Meas 2013; 21:378-400. [DOI: 10.1891/1061-3749.21.3.378] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.
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