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Tyagi S, Luo N, Tan CS, Tan KB, Tan BY, Menon E, Venketasubramanian N, Loh WC, Fan SH, Yang KLT, Swee Ling Chan A, Farwin A, Lukman ZB, Koh GCH. Qualitative study exploring heterogeneity in caregiving experiences post-stroke in Singapore. BMJ Open 2023; 13:e055988. [PMID: 36921949 PMCID: PMC10030476 DOI: 10.1136/bmjopen-2021-055988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE Stroke, a common illness in older adults, accounts for up to 4% of direct medical costs in developed nations. Informal caregiving contributing a significant proportion of economic burden post-stroke warrants a deeper understanding of the caregiving context to sustain caregiving arrangement. While literature exists describing differences in motivation and preferences of caregivers, limited literature explores differences in caregiving experiences of different types of caregivers (ie, spouse, adult-child, sibling or others). Addressing this gap, our study aimed to explore the caregiving experience of stroke survivors and their family caregivers across different caregiver identities in an Asian setting. DESIGN Qualitative descriptive study. SETTING Community setting. PARTICIPANTS We conducted semi-structured interviews with 26 stroke survivors and 35 caregivers purposively sampled from an outpatient rehabilitation setting, an outpatient clinic and a support organisation. Data were analysed using thematic analysis. OUTCOME MEASURES Themes including caregiving experience of stroke survivors and their family caregivers across different caregiver identities. RESULTS Following five themes were reported: caregiver reserve, coping strategies, caregiver burden, competing commitments and role of foreign domestic worker (FDW) in family caregiving. Spouse caregivers were less willing to ask for help, commonly adopted faith-based, and spacing or recharging types of coping, reported emotional strain and shared limited accounts of FDWs. Adult-child caregivers were more willing to ask for help, engaged in alternative care arrangements involving FDWs, commonly adopted action-focussed coping and reported multidimensional caregiver burden. CONCLUSION Our findings illustrated the heterogeneity in factors affecting caregiving experience across spouse and adult-child caregivers. Practical implications include conducting a needs assessment for caregiver-stroke survivor dyads and providing tailored support, training and information to help caregivers cope better.
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Affiliation(s)
- Shilpa Tyagi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Kelvin Bryan Tan
- Policy Research & Evaluation Division, Ministry of Health Singapore, Singapore
| | | | - Edward Menon
- Medical Services, St. Andrew's Community Hospital, Singapore
| | | | - Wei Chin Loh
- Rehabilitation, St. Andrew's Community Hospital, Singapore
| | - Shu Hui Fan
- Rehabilitation, St. Andrew's Community Hospital, Singapore
| | | | | | - Aysha Farwin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Kontou E, Thomas SA, Cobley C, Fisher R, Golding-Day MR, Walker MF. A Biopsychosocial Intervention for Stroke Carers (BISC): development and description of the intervention. Health Psychol Behav Med 2022; 10:92-103. [PMID: 34993008 PMCID: PMC8725872 DOI: 10.1080/21642850.2021.2016412] [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] [Indexed: 11/24/2022] Open
Abstract
Objective Family members of stroke survivors are often not supported for their caring role, with many reporting adjustment difficulties. This paper describes the development and content of a group-based intervention for informal carers of stroke survivors. Method The intervention is based on the theoretical foundation of the biopsychosocial model with the aim to understand and address the physical, psychological and social factors of caring for stroke survivors. Findings from a comprehensive literature review and a qualitative study with carers and stroke professionals were synthesized to guide the intervention development. The Template for Intervention Description and Replication (TIDieR) checklist was used as a framework to describe the intervention. Results The intervention integrates cognitive-behavioural approaches via the identification of the biopsychosocial (physical, emotional, social) factors that can have an impact on the well-being of carers. It includes education on stroke-specific topics and advice on coping strategies. It consists of six structured two-hour group sessions facilitated in a community setting. It provides information and support on adjusting to the caring role in the first year post-stroke. Intervention materials were designed for addressing carers’ specific needs using psychological techniques, such as problem-solving, goal setting and relaxation exercises. Conclusion We have underlined the importance for describing and reporting the process of intervention development for complex interventions in the context of stroke rehabilitation. An intervention addressing the needs of informal stroke carers (Biopsychosocial Intervention for Stroke Carers; BISC) has been developed and described. BISC was further evaluated in a single-centre feasibility randomized controlled trial.
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Affiliation(s)
- Eirini Kontou
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK.,Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Shirley A Thomas
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Christine Cobley
- Department of Clinical Psychology, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Rebecca Fisher
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Miriam R Golding-Day
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
| | - Marion F Walker
- School of Medicine, University of Nottingham, Medical School, Queen's Medical Centre, Nottingham, UK
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Kum C, Miller EL, Jones H, Kean EB, Kreitzer N, Bakas T. Theoretically Based Factors Affecting Stroke Family Caregiver Health: An Integrative Review. West J Nurs Res 2021; 44:338-351. [PMID: 34636275 DOI: 10.1177/01939459211050955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Stroke family caregivers often neglect their own health while providing care. Rigorous reviews have focused on stroke caregiver needs and outcomes; however, a comprehensive review of stroke caregiver health is lacking. The purpose of this integrative review was to determine factors associated with stroke family caregiver health. Using a PRISMA flow diagram and Rayyan software, 41 studies were identified published from January 2000 to December 2020. Databases included Cochrane Reviews, Cochrane Trials, PsycINFO, Ovid MEDLINE, PubMed, EBSCOhost MEDLINE, Embase, and CINAHL. Rigorous guidelines were used to critique the 41 articles. Health measures were global in nature, lacking details regarding health promotion activities important to stroke family caregiver health. Common factors associated with caregiver health were depressive symptoms and burden. Further research is needed to design more situation-specific instruments to measure stroke family caregiver health, as well as interventions to reduce depressive symptoms and burden while promoting caregiver health.
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Affiliation(s)
- Cleopatra Kum
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Elaine L Miller
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Holly Jones
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Emily B Kean
- University of Cincinnati, Health Sciences Library, Cincinnati, OH, USA
| | - Natalie Kreitzer
- University of Cincinnati, Department of Emergency Medicine, Cincinnati, OH, USA
| | - Tamilyn Bakas
- University of Cincinnati, College of Nursing, Cincinnati, OH, USA
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A scoping review on studies about the quality of life of informal caregivers of stroke survivors. Qual Life Res 2021; 31:1013-1032. [PMID: 34515916 DOI: 10.1007/s11136-021-02988-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the available evidence regarding the quality of life (QoL) of informal caregivers of stroke survivors, by identifying the instruments used to assess QoL, and its associated characteristics. METHODS A scoping review was performed, following PRISMA-ScR guidelines. The electronic databases PubMed, ISI Web of Science, PsycINFO, and SciELO were searched for empirical, peer-reviewed, original, and full-length studies on the characteristics influencing the QoL of informal caregivers of stroke survivors. Eligibility and data extraction were conducted by two independent researchers. The main quantitative findings were synthesized, and qualitative data were explored by thematic content analysis. RESULTS The included studies, 56 quantitative, 1 qualitative, and 1 mixed methods, were published between 1999 and 2020. A high heterogeneity was found regarding the assessment of QoL, and the characteristics influencing it. Only one study used an instrument specifically designed to assess the stroke caregivers' QoL. The QoL of informal caregivers was inversely associated with physical and mental health of stroke survivors and caregivers, while stroke characteristics with a better prognosis, caregivers' positive relationships, and a more supportive and participative social context were positively associated to QoL. CONCLUSION There is a need for standardizing the assessment of the QoL of informal caregivers of stroke survivors, as well as for investing in cross-country/cultural studies with robust mixed methods designs to allow a deeper understanding of the experiences of caregivers. Further research, policies, and practices should consider the diversity and complexity of the characteristics influencing QoL, to empower informal caregivers and improve their QoL.
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Bernardo LD, Pontes TB, Souza KID, Ferreira RG, Deodoro TMS, Almeida PHTQD. Activity card sort e o repertório ocupacional de idosos: uma revisão integrativa da literatura. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoar2130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução O Activity Card Sort (ACS) é uma ferramenta desenvolvida para avaliar a participação de idosos em atividades instrumentais de vida diária, sociais e de lazer de baixa e alta demanda. É considerado um instrumento de avaliação útil para o processo terapêutico ocupacional utilizando uma abordagem baseada nas ocupações e centrada no cliente. Objetivo Analisar as principais características da produção científica sobre a utilização do ACS na população de idosos. Método Foi realizada uma revisão integrativa da literatura. Para a seleção dos registros bibliográficos, foram selecionadas seis fontes de informação, sem recorte temporal. Na organização e análise dos dados, foi criada uma coleção dos registros bibliográficos para realizar a análise descritiva e, na construção e visualização de redes bibliométricas, foi aplicado o VOSviewer. Resultados A amostra foi composta por 67 artigos. Os objetivos das pesquisas eram direcionados a examinar as propriedades psicométricas do instrumento, utilizar o ACS para comprovar o impacto das deficiências na participação e engajamento em atividades ou usar o ACS como medida de desfecho em diferentes intervenções. Conclusão O instrumento se apresentou como uma opção que enriquece o processo avaliativo na terapia ocupacional, uma vez que apresentou boas propriedades psicométricas, foi capaz de capturar o nível de participação em diferentes populações, assim como pôde ser usado como medida de desfecho para intervenções que se preocupam com o engajamento em ocupações.
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Scholten EWM, Hillebregt CF, Ketelaar M, Visser-Meily JMA, Post MWM. Measures used to assess impact of providing care among informal caregivers of persons with stroke, spinal cord injury, or amputation: a systematic review. Disabil Rehabil 2019; 43:746-772. [PMID: 31366259 DOI: 10.1080/09638288.2019.1641847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE (1) To identify measures used to evaluate the impact of caregiving among caregivers of persons with stroke, spinal cord injury, and amputation; and (2) to systematically evaluate their clinimetric properties reported in validation studies. MATERIALS AND METHODS Two separate systematic reviews (Embase, PsycINFO, CINAHL, Pubmed/Medline) were conducted. COSMIN guidelines were used to assess clinimetric properties and methodological quality of studies. RESULTS (1) 154 studies published between 2008 and May 2019 were included, in which 48 measures were used, mostly describing negative impact. Thirty measures were used only once and not further described. (2) In general, structural validity, internal consistency, and hypothesis testing were often investigated. Reliability, cross-cultural and criterion validity to a lesser extent, and scale development and content validity were rarely described. Tests of measurement error and responsiveness were exceptional. Most supporting evidence was found for the Zarit Burden Interview Short Form, Caregiver Burden Scale and Positive Aspects of Caregiving Questionnaire. CONCLUSIONS There is a wide variety of impact of caregiving measures. The present study provided a detailed overview of what is known about clinimetric characteristics of 18 different measures repeatedly used in research. The overview provides clinicians a guidance of appropriate measure selection. PROSPERO REGISTRATION CRD42018094796IMPLICATIONS FOR REHABILITATIONClinicians should be aware that information about measure development and clinimetric properties for most measures used to assess impact of informal caregiving is incomplete.Most supporting evidence was found for the Zarit Burden Interview Short Form, Caregiver Burden Scale and Positive Aspects of Caregiving Questionnaire.This overview of clinimetric properties provides clinicians guidance for selection of an appropriate measure.
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Affiliation(s)
- Eline W M Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Chantal F Hillebregt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMCU Utrecht Brain Center, University Medical Center, Utrecht, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Watford P, Jewell V, Atler K. Increasing Meaningful Occupation for Women Who Provide Care for Their Spouse: A Pilot Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2019; 39:213-221. [PMID: 30810080 DOI: 10.1177/1539449219829849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Caregiving for a loved one can be difficult and negatively affect health and quality of life. This pilot mixed-method study explored an intervention to increase participation in meaningful occupation for women who care for their spouse. Participants completed the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) and Canadian Occupational Performance Measure (COPM). The 4-week intervention consisted of an activity log (Daily Experiences of Pleasure, Productivity, and Restoration Profile) and a reflective journal (Journal of Activities and Experiences). Researchers analyzed data from the reflective journal using content analysis. Preliminary findings showed an increase in the physical health domain (p < .05), and satisfaction with meaningful activities had clinical significance. Qualitative themes included caregiving is a demanding role, writing down experiences helped caregivers take action, and caregivers reorganized daily activities. Although preliminary results showed a positive trend, the intervention was brief, and more research is needed to determine whether greater gains are possible, and can be sustained.
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Affiliation(s)
| | | | - Karen Atler
- Colorado State University, Fort Collins, USA
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8
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Jellema S, Wijnen MAM, Steultjens EMJ, Nijhuis-van der Sanden MWG, van der Sande R. Valued activities and informal caregiving in stroke: a scoping review. Disabil Rehabil 2018; 41:2223-2234. [DOI: 10.1080/09638288.2018.1460625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Sandra Jellema
- Scientific Institute for Quality of Healthcare, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Mandy A. M. Wijnen
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Esther M. J. Steultjens
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maria W. G. Nijhuis-van der Sanden
- Scientific Institute for Quality of Healthcare, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Rob van der Sande
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
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9
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Wingrove C, Rickwood D. Parents and carers of young people with mental ill-health: What factors mediate the effect of burden on stress? COUNSELLING PSYCHOLOGY QUARTERLY 2017. [DOI: 10.1080/09515070.2017.1384362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chelsi Wingrove
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, Australia
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10
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Katbamna S, Manning L, Mistri A, Johnson M, Robinson T. Balancing satisfaction and stress: carer burden among White and British Asian Indian carers of stroke survivors. ETHNICITY & HEALTH 2017; 22:425-441. [PMID: 27744714 DOI: 10.1080/13557858.2016.1244740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This paper presents the findings of a qualitative study exploring White and British Indian informal stroke carers' experiences of caring, factors contributing to their stress, and strategies used to overcome stress. DESIGN A qualitative approach involving in-depth interviews was used to explore informal carers' experiences of caring for stroke survivors and the stress of caring at one and three to six months from the onset of stroke. Interviewers bilingual in English and Gujarati or Punjabi conducted interviews with carers. Socio-demographic data of carers and stroke survivors were collected at one, and three to six months by dedicated stroke research nurses. RESULTS A total of 37 interviews with carers caring for stroke survivors with a wide range of physical and mental impairments were completed. A majority of carers had assumed the task of caring within a few weeks of the stroke. Irrespective of ethnicity, carers' emotional and physical well-being was undermined by the uncertainty and unpredictability of caring for stroke survivors, and meeting their expectations and needs. The strain of managing social obligations to care was common to all carers irrespective of gender and ethnicity, but the higher levels of anxiety and depression reported by Indian British female carers appeared to stem from the carers' pre-existing physical ailments, their cultural and religious beliefs, and household arrangements. Carers' strain in extended households was exacerbated by the additional responsibility of caring for other dependent relatives. CONCLUSION Since the role of carers is clearly indispensable in the successful rehabilitation of survivors, it is vital to ensure that their well-being is not undermined by a lack of information and training, and that their need for professional support is prioritised.
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Affiliation(s)
- Savita Katbamna
- a Department of Health Science , University of Leicester , UK
| | - Lisa Manning
- b Department of Stroke Medicine , University Hospitals of Leicester NHS Trust , Leicester , UK
| | - Amit Mistri
- b Department of Stroke Medicine , University Hospitals of Leicester NHS Trust , Leicester , UK
| | - Mark Johnson
- c School of Applied Social Sciences, Mary Seacole Research Centre , De Montfort University , Leicester , UK
| | - Thompson Robinson
- d Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease , University of Leicester , Leicester , UK
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Brasier C, Ski CF, Thompson DR, Cameron J, O'Brien CL, Lautenschlager NT, Gonzales G, Hsueh YSA, Moore G, Knowles SR, Rossell SL, Haselden R, Castle DJ. The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial. Trials 2016; 17:446. [PMID: 27612562 PMCID: PMC5018183 DOI: 10.1186/s13063-016-1559-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers. METHODS This study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8 + 1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health-related quality of life (AQoL-6D and EQ-5D) and self-efficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI-SF and CEQ). Process evaluation and a health economic cost analysis will also be conducted. DISCUSSION We believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment-related costs in this vulnerable patient-carer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self-management. TRIAL REGISTRATION ACTRN12615001046594 . Registered on 7 October 2015.
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Affiliation(s)
- Catherine Brasier
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - Chantal F Ski
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia. .,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia. .,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.
| | - David R Thompson
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jan Cameron
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - Casey L O'Brien
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Nicola T Lautenschlager
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, VIC, 3052, Australia
| | - Graeme Gonzales
- Department of Neurology, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Ya-Seng Arthur Hsueh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Gaye Moore
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Simon R Knowles
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.,Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia
| | - Susan L Rossell
- Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia
| | - Rachel Haselden
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - David J Castle
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
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12
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Ski CF, Thompson DR, Castle DJ. Trialling of an optimal health programme (OHP) across chronic disease. Trials 2016; 17:445. [PMID: 27612634 PMCID: PMC5018188 DOI: 10.1186/s13063-016-1560-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 08/20/2016] [Indexed: 11/11/2022] Open
Abstract
Population ageing is a worldwide phenomenon, most advanced in developed countries and expected to continue over the next few decades. As people are surviving longer with age-associated disease and disability, there is an imperative to identify innovative solutions for an already overburdened health care system. Such innovations need to be focused on disease management, taking into consideration the strong associations that have been established between psychosocial factors and pathophysiological mechanisms associated with chronic disease. Aside from personal and community costs, chronic diseases produce a significant economic burden due to the culmination of health care costs and lost productivity. This commentary reports on a programme of research, Translating Research, Integrated Public Health Outcomes and Delivery, which will evaluate an optimal health programme that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of those with chronic disease. The effectiveness of the optimal health programme will be evaluated across three of the most significant contributors to disease burden: diabetes mellitus, chronic kidney disease and stroke. Cost-effectiveness will also be evaluated. The findings derived from this series of randomised controlled trials will also provide evidence attesting to the potential applicability of the optimal health programme in other chronic conditions.
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Affiliation(s)
- Chantal F Ski
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia. .,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia. .,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.
| | - David R Thompson
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - David J Castle
- Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
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13
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Thomas KE, Broady TR, James CL. Exploring manual handling practices by informal carers. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.7.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims: Manual handling is a significant component in the role of an informal carer. This research aimed to understand the manual handling needs and practices of informal primary carers. Methods: This qualitative study utilised semi-structured face-to-face interviews to gather data from one male and female carer living in the community with a spouse with Parkinson's disease. Using comparative thematic analysis, categories and themes emerged from the detailed descriptions of the lived experiences. Findings: Three main themes emerged from the data: 1. Carer experience: manual handling was a daily task, however care recipients sometimes assisted in a modified environment; and carers utilised previous experiences; 2. Equipment: a variety of prescribed and non-prescribed equipment was used, however limited training was provided; 3. Perceived needs: identified needs included education on manual handling techniques, physical exercises for carers, equipment information, financial assistance for equipment and increased formal support. Conclusions: A lack of assistance for Australian informal carers with manual handling in relation to information provision, training and awareness of equipment and supports was highlighted. There is a need for increased carer awareness of services and support group networks, as well as for health professionals to deliver relevant advice to carers as part of service provision to care recipients.
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Affiliation(s)
- Kate E Thomas
- Occupational therapist, Prince of Wales Hospital, Sydney, Australia
| | - Timothy R Broady
- Senior research and development officer, Carers NSW, Sydney, Australia
| | - Carole L James
- Associate professor, School of Health Sciences, University of Newcastle, NSW, Australia
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O’Brien CL, Moore G, Rolley JX, Ski CF, Thompson DR, Lautenschlager NT, Gonzales G, Hsueh YS(A, Castle D. Exploring Health Care Providers’ Perceptions of the Needs of Stroke Carers: Informing Development of an Optimal Health Program. Top Stroke Rehabil 2014; 21:421-31. [DOI: 10.1310/tsr2105-421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Posters. Br J Occup Ther 2014. [DOI: 10.1177/03080226140770s804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kniepmann K. Family Caregiving for Husbands with Stroke: An Occupational Perspective on Leisure in the Stress Process. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2014; 34:131-40. [DOI: 10.3928/15394492-20140325-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 02/27/2014] [Indexed: 11/20/2022]
Abstract
This study adapted the Stress Process Model with occupational assessments to identify stress, leisure changes, burden levels, and health-related quality of life in 20 caregivers of working-age husbands with mild to moderate stroke in the past 2 years. Primary stress was based on participants' perceptions of their husbands' functional behavior skills. Secondary strain was indicated by reduction of leisure activities that the caregivers wished to still do or do more—a phenomena labeled Leisure Loss. Outcomes were burden and health-related quality of life. Wives whose husbands had more functional behavior difficulties experienced significantly more Leisure Loss. Wives with Leisure Loss had significantly higher burden scores than those who continued their leisure participation, but health-related quality of life scores were not different. These findings suggest that leisure participation is important as health promotion for family caregivers, with potential to enhance health of the relative with stroke and the entire family.
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White JH, Patterson K, Jordan LA, Magin P, Attia J, Sturm JW. The experience of urinary incontinence in stroke survivors: A follow-up qualitative study. The Canadian Journal of Occupational Therapy 2014; 81:124-34. [DOI: 10.1177/0008417414527257] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. No previous qualitative exploration of urinary incontinence (UI) or post-stroke urinary incontinence (PSUI) has been undertaken in an Australian population. Purpose. The purpose of this study is to explore the experiences of community-dwelling stroke survivors who were living with UI/PSUI and understand how context shaped those experiences. Methods. A pragmatic approach using thematic analysis was employed for this study. Findings. Four themes emerged from the data: “I’ve got to go”: onset and daily experience of UI; “No one ever mentioned it”: lack of advice and information from the health system; “You can’t enjoy something if you’ve got to go the toilet”: experience of occupational restrictions; and “It’s just a matter of planning”: management strategies. Implications. UI continued well beyond discharge and was shaped by limited advice, distress, and role loss. Occupational therapists are encouraged to engage in assessment, management, and treatment of UI, including the provision of education that promotes continence, attenuates negative experiences, and enhances community participation.
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Abstract
Introduction: Stroke is a leading cause of disability worldwide. While health services focus on the needs of diagnosed persons, families provide extensive informal care with diverse effects on daily life and health. Understanding caregivers' experience is critical to support their health and sustained contributions. This exploratory study examined how caring for partners with stroke and aphasia impacts caregivers' activities, identifying possible differences according to race/ethnicity through the lens of occupation. Method: Mixed methods identified the occupational impact of caring for a partner with stroke and aphasia. Twelve participants completed the Carer Communication Outcome After Stroke, Occupational Gaps Questionnaire, Activity Card Sort, and a semi-structured interview. Findings: The impact of aphasia on caregivers varied greatly. The Occupational Gaps Questionnaire revealed gaps in cultural activities. On the Activity Card Sort, caregivers experienced occupational loss, primarily in low-demand leisure and social activities. Six themes emerged from the interviews: personal factors, finding new equilibrium, participation barriers, compensations for aphasia, uncertainty, and obligations. Trends differed somewhat by race/ethnicity. Conclusion: Findings have implications for health professionals working with individuals with stroke and aphasia. The caregivers' experience deserves attention to support their quality of life and wellbeing, which can promote sustained assistance for their relatives with stroke.
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Affiliation(s)
- Kathy Kniepmann
- Instructor in Occupational Therapy and Neurology, Washington University in St Louis — Occupational Therapy St Louis, Missouri, United States
| | - Molly Harlacker Cupler
- Occupational Therapist, Clinical Associates of the Finger Lakes, Victor, NY, United States
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