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Paschalidou K, Tsitskari E, Tsiakiri A, Makri E, Vlotinou P, Vadikolias K, Aggelousis N. Exploring Stroke Patients' Needs: A Cultural Adaptation and Validation of the Modified Needs Assessment Questionnaire in a Greek Context. Healthcare (Basel) 2024; 12:1274. [PMID: 38998809 PMCID: PMC11241691 DOI: 10.3390/healthcare12131274] [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: 04/23/2024] [Revised: 05/30/2024] [Accepted: 06/23/2024] [Indexed: 07/14/2024] Open
Abstract
Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally the research sought to identify potential differences in the assessment of stroke patients' needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors adhering to World Health Organization guidelines and providing autonomous consent participated in the study. The mNAQ comprising 141 items across 12 domains was utilized to evaluate stroke patients' needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory factor analysis, exploratory factor analysis and Cronbach's reliability analysis to establish construct validity and internal consistency. Concurrent and known-groups validity analyses were conducted; and Spearman's rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications guided by confirmatory and exploratory factor analyses resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively differentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for comprehensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care improving functional outcomes and ultimately enhancing the overall well-being and quality of life for stroke survivors.
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Affiliation(s)
- Katerina Paschalidou
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.P.); (E.T.); (E.M.); (N.A.)
| | - Efi Tsitskari
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.P.); (E.T.); (E.M.); (N.A.)
| | - Anna Tsiakiri
- Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Evangelia Makri
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.P.); (E.T.); (E.M.); (N.A.)
| | - Pinelopi Vlotinou
- Department of Occupational Therapy, University of West Attica, 12243 Athens, Greece;
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (K.P.); (E.T.); (E.M.); (N.A.)
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Martins Dos Santos H, Pereira GS, de Oliveira LC, Da Silva PK, Gonçalves Lima M, Faria CDCDM, Silva SM. Biopsychosocial factors associated with the state of disability after hemiparesis in the chronic phase of stroke: exploratory analysis based on the International Classification of Functioning, Disability and Health. Disabil Rehabil 2024; 46:1366-1373. [PMID: 37029629 DOI: 10.1080/09638288.2023.2196444] [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: 07/12/2022] [Accepted: 03/24/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE To identify the main biopsychosocial factors associated with disability level after stroke using the International Classification of Functioning, Disability and Health (ICF) model. METHODS A cross-sectional study was conducted with chronic stroke survivors. Disability was assessed using the World Health Disability Assessment Schedule 2.0. The independent variables were: Body functions: emotional functioning and whether the dominant upper limb was affected. For the Activities & Participation component, satisfaction regarding the execution of activities and participation were assessed using the SATIS-Stroke, as well as the locomotion ability for adults (ABILOCO), manual ability (ABILHAND) and the return to work. For environmental factors, income and facilitators and obstacles were assessed using the Measure of the Quality of the Environment (MQE). Personal factors: age and sex. Multiple Linear Regression was employed. RESULTS Limited locomotor ability (β = -0.281; t = -3.231 p = 0.002), dissatisfaction regarding activities and participation (β = -0.273; t = -3.070 p = 0.003), and the non-return to work (β = 0.162; t = 2.085 p = 0.04) were associated with disability. CONCLUSION The reduction in locomotor ability, dissatisfaction regarding activities and participation and the non-return to work were associated with disability in the chronic phase following a stroke.
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Affiliation(s)
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Leia Cordeiro de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Paula Karina Da Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Michael Gonçalves Lima
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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Charumbira MY, Berner K, Louw QA. Functioning Problems Associated with Health Conditions with Greatest Disease Burden in South Africa: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315636. [PMID: 36497710 PMCID: PMC9735592 DOI: 10.3390/ijerph192315636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 05/05/2023]
Abstract
A notable rise in health-related disability for which evidence-based rehabilitation is beneficial is evident in low-to-middle income countries. This scoping review aimed to systematically identify and map the most common functioning problems associated with health conditions that contribute most to disability in South Africa using the International Classification of Functioning, Disability and Health (ICF) framework. Peer-reviewed evidence published from January 2006 to December 2021 was systematically searched from five databases. Some 268 studies reporting on functioning problems (impairments, activity limitations, and participation restrictions) in South African adults (>18 years) related to 10 health conditions were included. A total of 130 different functioning problems were mapped to the ICF. The most prevalent problems (top 20) were related to mobility, pain, and mental health but spanned across several ICF domains and were mostly in patients at primary care. The high prevalence and wide range of functioning problems may be particularly burdensome on an already strained primary health care (PHC) system. This points towards targeted planning of innovative strategies towards strengthening rehabilitation service delivery at primary care to address these complexities where there is an inadequate rehabilitation workforce.
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Volunteer Engagement in a Stroke Self-Management Program: Qualitative Analysis of a Hybrid Team of Healthcare Providers and Trained Volunteers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159341. [PMID: 35954697 PMCID: PMC9367766 DOI: 10.3390/ijerph19159341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/21/2022]
Abstract
Stroke recovery is a complex, multidimensional and heterogeneous process. Volunteer engagement improves the delivery of interventions in stroke rehabilitation programs but is under-utilized due to poor role clarity and other program-related concerns. We evaluated healthcare providers’ and volunteers’ perceptions of volunteer engagement in an 8-week self-management program that provided self-management support for community-dwelling stroke survivors. Using a qualitative design, we conducted individual, semi-structured interviews with a purposive sample of 5 trained healthcare providers and 18 volunteers. The participants shared their experiences of supporting survivors, perceptions of volunteer engagement, and areas of improvement to optimize volunteer support. Three main themes and six subthemes emerged: bilateral exchange between healthcare providers/volunteers and survivors; adoption of individualized approaches; and suggestions for optimizing volunteer contributions. Volunteer engagement can be optimized by developing well-designed programs with sufficient role clarity, strengthened collaborations with healthcare providers and adequate training. Our findings highlighted the contributions of trained volunteers in supporting stroke survivors’ self-management. Future research should evaluate the use of peer and healthcare professional volunteers in such programs and build community capacity to support stroke survivors’ recovery.
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dos Santos HM, Pereira GS, de Oliveira LC, da Silva PK, Lima MG, Feliz VHADA, Faria CDCDM, Silva SM. Diagnostic accuracy of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to estimate disability after stroke. Disabil Rehabil 2022:1-6. [DOI: 10.1080/09638288.2022.2080876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Heyriane Martins dos Santos
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Leia Cordeiro de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Paula Karina da Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Michael Gonçalves Lima
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | | | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Dos Santos HM, Pereira GS, Brandão TCP, Ramon FMV, Bazán JAP, Bissoli MEF, Faria CDCDM, Silva SM. Impact of Environmental Factors on Post-Stroke Disability: An Analytical Cross-Sectional Study. J Stroke Cerebrovasc Dis 2022; 31:106305. [PMID: 35093631 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106305] [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: 10/27/2021] [Revised: 12/10/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Identify how environmental barriers and facilitators are associated with disability in stroke survivors. MATERIALS AND METHODS An analytical, cross-sectional study was conducted involving individuals in the chronic stage of stroke. The dependent variable was disability, which was assessed using the World Health Organization Disability Assessment Schedule (WHODAS-2.0). Environmental factors (independent variable) were evaluated using the Measure of the Quality of the Environment (MQE). Multiple linear regression analysis was performed to estimate the impact of the environment on disability following a stroke. RESULTS Seventy-five individuals (mean age: 54.2 + 9.8 years) were analyzed. The most frequent environmental facilitators were related to technology, social networks, and public services. The main barriers were related to the physical environment. Environmental barrier was a predictor of both overall disability [F(1.73) = 4.24; R2=0.06; β = -0.23; t = -2.06; p=0.04] and participation [F(1.73) = 10.45; R2=0.13; β = -0.35; t = -3.23; p = 0.01]. Environmental facilitators were not correlated with disability. CONCLUSION Environmental barriers explained 13% of the variation in restrictions to social participation and were also a significant predictor of overall disability. The main barriers were related to the physical environment. Identifying environmental factors related to disability in stroke victims can assist in the planning of guided therapy.
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Affiliation(s)
- Heyriane Martins Dos Santos
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | | | | | | | | | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.
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Jen HJ, Kao CM, Chang KH, Yen CF, Liao HF, Chi WC, Chung WK, Liou TH. Assessment of functioning using the WHODAS 2.0 among people with stroke in Taiwan: A 4-year follow-up study. Ann Phys Rehabil Med 2021; 64:101442. [PMID: 33069868 DOI: 10.1016/j.rehab.2020.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Stroke is a leading cause of long-term disability and is considered a major global health burden. OBJECTIVES We aimed to explore the 4-year changes in disability among patients with stroke under the existing health care system in Taiwan. METHODS We used the "Taiwan Data Bank of Persons with Disability" (TDPD), which collects data on candidates nationwide who want to apply for government benefits or social welfare. We included adults>18 years with stroke who were registered between July 11, 2012 and October 31, 2018. This was a longitudinal follow-up study with 2 times of assessments. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to evaluate function initially and at 4-year follow-up. Generalized estimating equations (GEE) were used to analyse changes in disability over 4 years and interaction effects. RESULTS A total of 3506 participants (2080 men) with mean age 62.2 (12.5) years and followed up for more than 4 years were included. Generally, participants with stroke showed improved function over the 4 years. Domain scores of mobility, participation, life activities, and overall score significant improved from 55.9 to 54.3, 53.0 to 43.6, 70.9 to 67.4, and 49.8 to 47.3, respectively (P<0.05). With respect to upper- and lower-limb motor deficiency, participants who required assistance or who were dependent showed significant improvement (P<0.05) in most of the WHODAS 2.0 domains except cognition. Younger patients (<65 years) tended to have significantly better outcomes, and institutionalized residents tended to show a significant and considerable deterioration in all WHODAS 2.0 domains. CONCLUSION Participants with stroke showed an improvement in levels of functioning, specifically in mobility, participation, and life activities, over 4 years of follow-up.
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Affiliation(s)
- Hsiu-Ju Jen
- Department of nursing, Taipei medical university, Shuang Ho hospital, New Taipei, Taiwan; School of nursing, college of nursing, Taipei medical university, Taipei, Taiwan.
| | - Chia-Man Kao
- Department of nursing, Taipei medical university, Shuang Ho hospital, New Taipei, Taiwan.
| | - Kwang-Hwa Chang
- Department of physical medicine and rehabilitation, school of medicine, college of medicine, Taipei medical university, Taipei, Taiwan; Graduate institute of injury prevention and control, college of public health, Taipei medical university, Taipei, Taiwan; Department of physical medicine and rehabilitation, Taipei medical university, Wan Fang hospital, Taipei, Taiwan.
| | - Chia-Feng Yen
- Department of public health, Tzu Chi university, Hualien, Taiwan.
| | - Hua-Fang Liao
- Taiwan Society of International Classification of Functioning, Disability and Health, Taipei, Taiwan; School and graduate institute of physical therapy, college of medicine, National Taiwan university, Taipei, Taiwan.
| | - Wen-Chou Chi
- Department of occupational therapy, Chung Shan medical university, Taichung, Taiwan.
| | - Wen-Kuei Chung
- Department of physical medicine and rehabilitation, Taipei medical university, Wan Fang hospital, Taipei, Taiwan.
| | - Tsan-Hon Liou
- Department of physical medicine and rehabilitation, school of medicine, college of medicine, Taipei medical university, Taipei, Taiwan; Taiwan Society of International Classification of Functioning, Disability and Health, Taipei, Taiwan.
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Olaoye OA, Soeker SM, Anthea R. Predictors of return to work among stroke survivors in south-west Nigeria. Hong Kong J Occup Ther 2021; 34:13-22. [PMID: 34408555 PMCID: PMC8366211 DOI: 10.1177/1569186120926614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/20/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Stroke is acknowledged globally and among Nigerian rehabilitation researchers as a public health problem that leaves half of its survivors with significant neurological deficits and inability to re-establish pre-existing roles. Consequent to the dearth of country specific data on return to work and its determinants for stroke survivors in Nigeria, this study investigated the predictors of return to work among stroke survivors in south-west Nigeria. METHOD Two hundred and ten stroke survivors from five tertiary health facilities in Osun state, Nigeria responded to a validated three-section questionnaire assessing return to work rates and its determinants after stroke in this study. Collected data were analysed using descriptive statistics and inferential statistic of chi-square, t-test and multiple logistic regression. RESULT The mean age of the respondents was 52.90 ± 7.92 years. Over 60% of the respondents returned to work with about half of them in full time employment (32.9%). Majority of the respondents noted that travel to and from work (43.8%) and access at work (43.3%) had an impact on their ability to work. The symptoms of stroke (odds ratio (OR) = 0.87), the environment (OR = 0.83), body function impairments (OR = 0.86) as well as activity and participation problems (OR = 0.80) were the significant predictors of return to work. Hemiplegia or paresis of the non-dominant side of the body was associated with a higher chance of return to work (OR = 7.64). CONCLUSION Body function impairments, activity and participation problems were independent predictors of return to work after stroke. Similarly, side of hemiplegia plays a prominent role in resumption of the worker role of stroke survivors in south-west Nigeria.
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Affiliation(s)
- Olumide Ayoola Olaoye
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ife, Nigeria
| | - Shaheed Moghammad Soeker
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Rhoda Anthea
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Keyser L, Myer ENB, McKinney J, Maroyi R, Mukwege D, Chen CCG. Function and disability status among women with fistula using WHODAS2.0: A descriptive study from Rwanda and Democratic Republic of Congo. Int J Gynaecol Obstet 2021; 157:277-282. [PMID: 33971022 DOI: 10.1002/ijgo.13740] [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: 01/25/2021] [Revised: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess function and disability among women in Rwanda and Democratic Republic of Congo living with fistula and identify characteristics associated with higher disability scores. METHODS Women presenting for fistula care were recruited. Eligible participants underwent a physical examination to classify fistula type and completed the WHO Disability Assessment Schedule 2.0 questionnaire to ascertain the impact of fistula on function across six domains: cognition, mobility, self-care, getting along, life activities, and participation. Disability scores were calculated (where 0 = no disability and 100 = complete disability). Participants were grouped according to no, low, or high disability status; results were examined to determine the domains most affected. RESULTS Among 69 participants, fistula type included: vesicovaginal (59.4%), ureterovaginal (14.5%), total absence of proximal urethra (11.6%), and rectovaginal (14.5%). Median disability score was 43.0/100 (interquartile range 26.0-67.0); 83% exhibited high disability status. Life activities and participation in society domains were most affected. Women with rectovaginal fistula reported the lowest scores, and those with total absence of proximal urethra reported the highest scores. CONCLUSION WHO Disability Assessment Schedule 2.0 represents a simple, robust measure of global disability status, aligns with research efforts to estimate maternal disability, and may inform health needs and resource allocation for this population. In this study, disability was common, varied by fistula type, and affected physical, mental, and social domains.
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Affiliation(s)
- Laura Keyser
- Andrews University, Berrien Springs, MI, USA.,Mama LLC, Boston, MA, USA
| | | | - Jessica McKinney
- Andrews University, Berrien Springs, MI, USA.,Mama LLC, Boston, MA, USA
| | - Raha Maroyi
- Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo.,Université Evangélique en Afrique, Bukavu, Democratic Republic of Congo
| | - Denis Mukwege
- Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo.,Université Evangélique en Afrique, Bukavu, Democratic Republic of Congo
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Ntsiea MV. Current stroke rehabilitation services and physiotherapy research in South Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:475. [PMID: 31392288 PMCID: PMC6676941 DOI: 10.4102/sajp.v75i1.475] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 04/01/2019] [Indexed: 01/19/2023] Open
Abstract
Background Stroke is one of the most common causes of morbidity and disability in South Africa, with the burden of stroke particularly high in rural South Africa. Objectives The aim of this study was to collate South African (SA) physiotherapy stroke rehabilitation research. Method A narrative review of physiotherapy stroke rehabilitation research conducted within the last 10 years in South Africa. Results Stroke survivors in South Africa have poor functional ability at discharge from the hospital and have poor access to transport, work and education. Their caregivers experience strain and have a poor quality of life. Inpatient rehabilitation services focus on the medical model approach and patients are discharged into family care because of limited rehabilitation facilities. Physiotherapy interventions found to be effective in SA studies: longitudinal shoulder strapping, balance exercises in the community, task-orientated circuit gait training, saccadic eye movement training with visual scanning exercises for unilateral spatial neglect and workplace intervention programmes to increase return to work after stroke. Caregiver education alone and use of pictorial exercise programmes does not improve patients’ functional ability and adherence to home exercise programmes, respectively. Conclusion There is a need to focus physiotherapy stroke rehabilitation on barriers that hinder full social integration of the patient, including return to work and improving carer support. Most research reviewed focused on description of the problems experienced; however, more intervention studies are now underway to develop context-specific interventions with feasible treatment intensity, frequencies and equipment requirements. Future research should explore new ways of improving post-discharge rehabilitation services. Examples of intervention research that may be beneficial in a SA context are mirror therapy, mental practice and patient-directed activities in rehabilitation. Clinical implications Knowledge of interventions that were found to be effective in this context will encourage clinicians to translate these findings into practice. Noting that outcome measures that are core for stroke rehabilitation are not included in some projects may remind researchers to consider them to make comparisons between different research projects.
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Affiliation(s)
- Mokgobadibe V Ntsiea
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Basheti IA, Ayasrah SM, Ahmad M. Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study. Saudi Pharm J 2018; 27:208-219. [PMID: 30766431 PMCID: PMC6362176 DOI: 10.1016/j.jsps.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/16/2018] [Indexed: 11/03/2022] Open
Abstract
Background Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. Objectives To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored. Methods This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient's factors were explored through multiple regression analysis.Key findings:Out of 198 stroke patients (mean age: 56.6 ± 14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ± 1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life. Conclusion Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.
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Affiliation(s)
- Iman A Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Elloker T, Rhoda AJ. The relationship between social support and participation in stroke: A systematic review. Afr J Disabil 2018; 7:357. [PMID: 30349808 PMCID: PMC6191741 DOI: 10.4102/ajod.v7i0.357] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 06/21/2018] [Indexed: 11/03/2022] Open
Abstract
Background The incidence of cerebrovascular accidents with its devastating effects on individuals is increasing. Post-stroke, restrictions in participation are common and social support could have an influence on this. Social support provided to individuals post-stroke is vital, but the relationship between social support and participation is not well understood. Objectives This review aimed to systematically determine the relationship between social support and participation post-stroke, based on the literature available. Method Ebscohost, Science Direct, Biomed Central, Cochrane Library, Google Scholar, Pedro Central and Wiley Online were the electronic databases searched between 2001 and 2016. Articles were deemed to be eligible if they met the inclusion criteria and successfully underwent scrutiny to determine their relevance and methodological quality, using tools from the Critical Appraisal Skills Programme and Milton Keynes Primary Trust. A narrative synthesis method was used to analyse the included studies. Results A total of 54 articles were identified after screening, and six articles were deemed eligible for inclusion. The articles consisted of cross-sectional, qualitative and cohort studies. Articles showed distinct, significant relationships between social support and participation where the quality and quantity of social support were important. High levels of social support had a positive influence on participation, social and leisure activities, as well as returning to work post-stroke. Conclusion A positive relationship exists between social support and participation post-stroke. Health professionals need to include social support interventions when attempting to manage the individual with stroke holistically, as this will have positive effects on participation.
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Affiliation(s)
- Toughieda Elloker
- Department of Physiotherapy, University of the Western Cape, South Africa
| | - Anthea J Rhoda
- Faculty of Community and Health Sciences, University of the Western Cape, South Africa
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