Post-Stroke Experiences and Rehabilitation Needs of Community-Dwelling Chinese Stroke Survivors: A Qualitative Study

Chau, Janita Pak Chun; Lo, Suzanne Hoi Shan; Butt, Laveeza; Liang, Surui

doi:10.3390/ijerph192316345

Cited by 4 publications

(2 citation statements)

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“…5 However, survivors constantly felt helpless and unprepared post-discharge and questioned their ability to adapt to a life with poststroke challenges. [6][7][8] Self-management refers to a person's active participation in managing the symptoms, medical regimens, and psychosocial sequelae associated with one's condition. 9 An increasing number of studies show evidence of self-management support interventions on significantly improving health outcomes of survivors including their self-efficacy (SE), self-management behaviors, healthrelated quality of life, social participation, and depression.…”

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confidence: 99%

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Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial

Chau

Lau

et al. 2023

Stroke

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BACKGROUND: Stroke survivors constantly feel helpless and unprepared after discharge from hospitals. More flexible and pragmatic support are needed for their optimized recovery. We examined the effects of a virtual multidisciplinary stroke care clinic on survivors’ health and self-management outcomes. METHODS: A randomized controlled trial was conducted. Survivors were recruited from 10 hospitals and randomized at 1:1 ratio into the intervention or the control groups. Intervention group participants received the Virtual Multidisciplinary Stroke Care Clinic service (monthly online consultations with a nurse, follow-up phone calls, and access to an online platform). Control group participants received the usual care. Outcomes of self-efficacy (stroke self-efficacy questionnaire; primary), self-management behaviors (Stroke Self-Management Behaviors Performance Scale), social participation (reintegration to normal living index), and depression (Geriatric Depression Scale; secondary) were measured at baseline, and 3 and 6 months after commencing the intervention (post-randomization). A generalized estimating equations model was used to compare the differential changes in outcomes at 3 and 6 months with respect to baseline between 2 groups. RESULTS: Between July 2019 and June 2022, 335 eligible participants were enrolled in the study. Participants (intervention group; n=166) showed significantly greater improvements in outcomes of self-efficacy (group-by-time interaction regression coefficient, B=4.60 [95% CI, 0.16 to 9.05]), social participation (B=5.07 [95% CI, 0.61 to 9.53]), and depression (B=−2.33 [95% CI, −4.06 to −0.61]), and no significant improvement in performance of self-management behaviors (B=3.45, [95% CI, −0.87 to 7.77]), compared with the control group (n=169) right after the intervention (6 months after its commencement). Hedges’ g effect sizes of the intervention on outcomes: 0.19 to 0.36. CONCLUSIONS: The results provide some positive evidence on the usefulness of the Virtual Multidisciplinary Stroke Care Clinic service. The effect sizes are regarded as small to medium, which may not be of clinical relevance. The baseline levels in outcomes were in favor of the control group, the intervention effects might be overestimated. The service must be tested further to determine its effectiveness. REGISTRATION: URL: https://www.chictr.org.cn ; Unique identifier: ChiCTR1800016101

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“…5 However, survivors constantly felt helpless and unprepared post-discharge and questioned their ability to adapt to a life with poststroke challenges. 6–8…”

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confidence: 99%

Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial

Chau

Lau

et al. 2023

Stroke

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Rehabilitation at home – development of a sustainable model placing the person’s needs and environment at heart: Protocol for a multi-method project (Preprint)

Elf,

Norin,

Meijering

et al. 2024

JMIR Research Protocols

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Rehabilitation at home – development of a sustainable model placing the person’s needs and environment at heart: Protocol for a multi-method projec (Preprint)

Elf,

Norin,

Meijering

et al. 2024

Preprint

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BACKGROUND Each year, more than 1.5 million people in Europe have a stroke, and many experience disabilities leading to activity and participation restrictions. Despite this, rehabilitation often focuses on the person's physical functions and not on the whole life situation and opportunities to live an active life. Given that rehabilitation today often is provided in the person’s home, there is a need to develop new models that consider the rehabilitation process as situated in the everyday living environment of persons with stroke. This project is grounded in experiences from our ongoing research, where we study the importance of the home and home environments for health and participation among persons with stroke, rehabilitated at home. Earlier findings have shown unmet issues, which lead to suboptimal rehabilitation outcomes. There is a need for studies on how to use environmental resources to optimize stroke rehabilitation in the home setting. OBJECTIVE The overarching objective of the project is to develop a new practice model for rehabilitation where the needs of the person are the starting point and where the environment is considered. METHODS The project will be conducted in partnership with persons with stroke, significant others, healthcare professionals, and care managers. Results from a literature review will form the base for interviews with the stakeholders, followed by co-designing workshops aiming to create a new practice model. Focus groups will be held to refine the outcome of the workshops to a practice model. RESULTS This four-year project commenced in January 2023 and will continue until December 2026. The results of the literature review are, as of February 2024, currently being analyzed. The ethics application for the interviews and co-design phase was approved in October 2023 and data collection is ongoing during winter and spring 2023/2024. We will develop a practice model with stakeholders and refine it together with care managers and decision-makers. The outcome of the project is a practice model and implementation plan, which will be achieved in autumn 2026. CONCLUSIONS A supportive environment is important for facilitating participation in daily life. As knowledge is scarce on how the environment can support rehabilitation and people’s health, there is reason to explore this further. The new practice model may lead to improved quality of life and increased mobility for the large group of people who rehabilitate at home after a stroke.

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Post-Stroke Experiences and Rehabilitation Needs of Community-Dwelling Chinese Stroke Survivors: A Qualitative Study

Cited by 4 publications

References 40 publications

Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial

Virtual Multidisciplinary Stroke Care Clinic for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial

Rehabilitation at home – development of a sustainable model placing the person’s needs and environment at heart: Protocol for a multi-method project (Preprint)

Rehabilitation at home – development of a sustainable model placing the person’s needs and environment at heart: Protocol for a multi-method projec (Preprint)

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