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Hounsri K, Zhang J, Kalampakorn S, Boonyamalik P, Jirapongsuwan A, Wu VX, Klainin-Yobas P. Effectiveness of technology-based psychosocial interventions for improving health-related outcomes of family caregivers of stroke survivors: A systematic review and meta-analysis. J Clin Nurs 2024. [PMID: 39020515 DOI: 10.1111/jocn.17370] [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: 03/06/2024] [Revised: 02/17/2024] [Accepted: 07/04/2024] [Indexed: 07/19/2024]
Abstract
AIM To synthesize evidence regarding the effectiveness of technology-based psychosocial interventions in improving health-related outcomes among family caregivers of stroke survivors. DESIGN A systematic review and meta-analysis was reported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Randomized controlled trials that investigated the effects of psychosocial interventions delivered through information and communication technologies on self-efficacy, caregiving competence, caregiver burden, perceived social support, anxiety, depression, health-related quality of life and cost-effectiveness were included. Two researchers independently selected studies, extracted data, and appraised the quality of the included studies. Subgroup analysis, sensitivity analysis, and narrative synthesis were conducted. DATA SOURCES Ten electronic databases (PubMed, CENTRAL, Web of Science, Scopus, CINHAL, Embase, Institution of Electrical Engineers Xplore, Ovid Medline, PsycINFO, ProQuest Dissertations and Thesis) were searched up to February 2023. RESULTS Nineteen studies involving 1717 participants fulfilled the eligibility criteria. Technology-based psychosocial interventions significantly improved self-efficacy (SMD = .62), caregiving competence (SMD = .55), depression (SMD = -.25) and anxiety (SMD = -.35). However, perceived social support, caregiver burden, and health-related quality of life did not show significant improvements. Subgroup analyses revealed that the interventions, lasting from 4 to 6 weeks and encompassing comprehensive contents, exhibited larger effect sizes. None of the studies measured cost-effectiveness. CONCLUSION The technology-based psychosocial interventions are effective in enhancing self-efficacy and caregiving competence, as well as alleviating anxiety, and depression among family caregivers of stroke survivors. Future research should investigate interventions delivered through various digital platforms using well-designed RCTs with in-depth qualitative data collection and measurement of health and cost-effectiveness outcomes. IMPACT Through psychosocial interventions, healthcare providers in clinical and community settings, particularly nurses, could incorporate technologies into current stroke care practices. PATIENT OR PUBLIC CONTRIBUTION It is not applicable as this is a systematic review. REGISTRATION The protocol was registered on PROSPERO (CRD42023402871).
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Affiliation(s)
- Kanokwan Hounsri
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jinghua Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Surintorn Kalampakorn
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Plernpit Boonyamalik
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Ann Jirapongsuwan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Fernandes JB, Fernandes S, Domingos J, Castro C, Romão A, Graúdo S, Rosa G, Franco T, Ferreira AP, Chambino C, Ferreira B, Courela S, Ferreira MJ, Silva I, Tiago V, Morais MJ, Casal J, Pereira S, Godinho C. Motivational strategies used by health care professionals in stroke survivors in rehabilitation: a scoping review of experimental studies. Front Med (Lausanne) 2024; 11:1384414. [PMID: 38813377 PMCID: PMC11133544 DOI: 10.3389/fmed.2024.1384414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Cognitive and motor impairments are common among stroke survivors. Physical therapy is often used to improve the functional capacity of stroke survivors. However, limited adherence to rehabilitation programs is a challenge. Motivation plays a crucial role in the success of rehabilitation programs as it influences individual adherence to treatment and overall health outcomes. This review aims to identify current trends in motivational strategies used by healthcare professionals for stroke survivor rehabilitation. Methods Following the framework developed by Arksey and O'Malley, a scoping review was conducted. We performed a literature search using MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, Nursing & Allied Health, and MedicLatina databases. Results A total of 906 papers were identified. After selecting and analyzing the articles, 17 papers were included in this review. Health professionals use various strategies to motivate stroke survivors. These approaches include establishing a therapeutic alliance, improving patients' health literacy, defining realistic goals, fostering problem-solving skills, personalizing the rehabilitation program, showcasing success stories, utilizing persuasive techniques, offering encouragement and compliments, providing emotional support, and effectively managing symptoms. Conclusion The knowledge gathered in this review can guide healthcare professionals in helping patients overcome barriers to rehabilitation, improve their motivation, and ultimately enhance their recovery outcomes.
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Affiliation(s)
- Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Sónia Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Josefa Domingos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Cidália Castro
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Ana Romão
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Susana Graúdo
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Gonçalo Rosa
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Tânia Franco
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Patrícia Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Claudine Chambino
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Bruno Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Susana Courela
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Maria José Ferreira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Isabel Silva
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal
| | - Vera Tiago
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Maria João Morais
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Joana Casal
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Silvia Pereira
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
| | - Catarina Godinho
- Department of Nursing, Unidade Local de Saúde de Almada-Seixal, ACeS Almada-Seixal, UCC Seixal, Seixal, Portugal
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Zachry AH, Williams L, Chen M, Surbhi S, Bailey J. Efficacy Studies of Home-Based Occupational Therapy Services Following Stroke: A Scoping Review. Occup Ther Health Care 2024; 38:254-275. [PMID: 37300527 DOI: 10.1080/07380577.2023.2221735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
The aim of this scoping review was to review and assess recent studies on the efficacy of home-based occupational therapy interventions for adults post-stroke. The number of efficacy studies is limited. The few studies available suggest that occupational therapy delivered in home settings may improve outcomes for stroke patients. There is also limited use of occupation-based assessments, interventions, and outcome measures in studies addressing home-based occupational therapy. Methodologies should be improved to include contexts, caregiver training, and self-efficacy. Further high-quality studies are needed on the efficacy home-based occupational therapy services.
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Affiliation(s)
- Anne H Zachry
- Department of Occupational Therapy, UTHSC, Memphis, TN, USA
| | - Lee Williams
- Department of Occupational Therapy, UTHSC, Memphis, TN, USA
| | - Ming Chen
- Center for Health System Improvement, College of Medicine, UTHSC, Memphis, TN, USA
| | - Satya Surbhi
- Division of General Internal Medicine, Department of Medicine and Center for Health System Improvement, College of Medicine Director of Measurement and Reporting, Tennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jim Bailey
- Tennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN, USA
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Partanen T, Seppänen-Järvelä R, Hiekkala S, Lindh J. Telerehabilitation in the Finnish Outpatient Rehabilitation Setting from the Perspective of the Socio-Technical Systems Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6519. [PMID: 37569057 PMCID: PMC10419293 DOI: 10.3390/ijerph20156519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND In the development of effective telerehabilitation (TR) interventions, understanding the various characteristics affecting its practice is essential. Remote connection creates a new technically shaped environment for therapy and, therefore, previous therapy methods do not work the same way as before. OBJECTIVE The objective of this survey was to describe the practice of TR through the socio-technical theory approach. METHODS The 629 respondents to the online questionnaire included music therapists, occupational therapists, speech and language therapists, physiotherapists, and neuropsychologists. The materials consisted of five open-ended questions. The analysis combined data-based and theory-based analysis. RESULTS In the data-based content analysis, we identified three main categories and eight generic categories, whereas in the theory-based, we categorised the main results according to the Fit Between Individuals, Tasks, Technology, and Environment (FITTE) framework dimensions. TR is everyday-life based, it requires shared participation, and the approach has to include coaching and collaboration with the client and their close associates. The everyday-life environment is one of the main dimensions that affect all the other dimensions. CONCLUSIONS TR can be seen as technology-mediated home-based rehabilitation, as it can integrate rehabilitation into the client's everyday life. In TR, therapy becomes multilateral and it creates a new kind of shared partnership into outpatient therapy.
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Affiliation(s)
- Tuija Partanen
- Kela Research, Social Insurance Institution of Finland, FI-00250 Helsinki, Finland;
- Faculty of Social Sciences, University of Lapland, FI-96101 Rovaniemi, Finland;
| | | | - Sinikka Hiekkala
- The Finnish Association of People with Physical Disabilities, FI-00280 Helsinki, Finland;
| | - Jari Lindh
- Faculty of Social Sciences, University of Lapland, FI-96101 Rovaniemi, Finland;
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