Social isolation and outcomes post stroke

Boden‐Albala, Bernadette; Litwak, Eugene; Elkind, Mitchell S.V.; Rundek, Tatjana; Sacco, Ralph L.

doi:10.1212/01.wnl.0000163510.79351.af

Cited by 259 publications

(193 citation statements)

References 29 publications

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“…For example, suffering remains common at end of life; the majority (70-100%) of seriously or terminally ill patients experience pain, approximately 25-50% are depressed, and 15% experience spiritual distress (49)(50)(51). Social isolation is also common (52). Given the relationship between patient suffering and caregiver well-being, it is reasonable to expect that, to the extent that these symptoms are successfully treated, caregiver well-being should improve.…”

Section: Patient Suffering As a Target For Caregiver Interventionsmentioning

confidence: 99%

Improving Well-Being in Caregivers of Terminally Ill Patients. Making the Case for Patient Suffering as a Focus for Intervention Research

Hebert

Arnold

Schulz

2007

Journal of Pain and Symptom Management

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Family caregivers are integral to the care of patients with physical or mental impairments. Unfortunately, providing this care is often detrimental to the caregivers' health. As a result, in the last decade, there has been a proliferation of interventions designed to improve caregivers' wellbeing. Interventions for caregivers of persons at end-of-life, however, are relatively few in number and are often underdeveloped. They also are typically designed to help reduce the work of caregiving or to help caregivers cope with the physical and emotional demands of providing care. While useful, these interventions generally ignore a primary stressor for family caregivers-a loved one's suffering. Patient suffering, whether physical, psychosocial, or spiritual, has a major impact on family caregivers. However, interventions that focus on the relief of patient suffering as a way to improve caregiver well-being have rarely been tested. It is our view that more research in this area could lead to new and more effective interventions for family caregivers of seriously or terminally ill patients. In support of our view, we will define suffering and review the relationships between patient suffering and caregiver well-being. We will then discuss a conceptual framework for intervention design. Finally, we conclude with a discussion of implications and future directions for intervention research.

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Section: Patient Suffering As a Target For Caregiver Interventionsmentioning

confidence: 99%

Improving Well-Being in Caregivers of Terminally Ill Patients. Making the Case for Patient Suffering as a Focus for Intervention Research

Hebert

Arnold

Schulz

2007

Journal of Pain and Symptom Management

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“…They concluded that the influence of social relationships is comparable to other risk factors such as obesity, alcohol abuse and air pollution, and that having reduced social contact is 'equivalent to smoking up to 15 cigarettes a day (p43).' In terms of the stroke population, a study tracking 655 stroke survivors over five years reported that those who were socially isolated were 1.4 times more likely to have an adverse outcome event (myocardial infarction, recurrent stroke, death) (Boden-Albala, Litwak, Elkind, Rundek, & Sacco, 2005).…”

Section: Introductionmentioning

confidence: 99%

What Factors Predict Who Will Have a Strong Social Network Following a Stroke?

Northcott

Marshall

Hilari

2016

J Speech Lang Hear Res

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Results: 87 participants (37% with aphasia) were recruited; 71 (16% with aphasia) were followed up at six months. Social network scores declined post stroke (p = .001). While the Children and Relatives factors remained stable, the Friends factor significantly weakened (p <.001). Concurrent predictors of social network at six months were: perceived social support, ethnicity, aphasia and extended ADL (adjusted R 2 = .42). There were two baseline predictors: Permanent repository linkpre-morbid social network and aphasia (adjusted R 2 = .60).Conclusions: Social networks declined post stroke. Aphasia was the only stroke-related factor measured at the time of the stroke that predicted social network six months later.3

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“…Beside its role as cardiovascular risk factor (RF) per se, old age is often accompanied by social isolation and psychological derangements, which contribute to poor awareness of health problems, low compliance to treatment, impaired control of cardiovascular RFs and ultimately, increased number of cardiovascular events. [1][2][3][4] Moreover, cross-sectional [5][6] and prospective studies 7 have demonstrated that educational and socio-economic levels also exert a remarkable effect on the prevalence of cardiovascular RFs, patient awareness and compliance and clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Improvement of cardiovascular risk profile in an elderly population of low social level: the ICON (Improving Cardiovascular risk profile in Older Neapolitans) study

et al. 2006

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Older age and low socio-economic conditions are associated with poor control of cardiovascular risk factors (RFs). We assessed the prevalence and awareness of cardiovascular RFs in 503 elderly outpatients of low social status attending two public Internal Medicine clinics in Naples, and studied the interaction of education and employment level with risk profile. The therapeutic intervention was oriented to improve patients' motivation through a positive patient-physician relationship, in keeping with the current guidelines for hypertension. The effect of treatment was evaluated by comparing retrospectively the level of cardiovascular RFs at baseline and at the last follow-up examination performed within 31 October 2005. Only 33.3% of patients (age ¼ 6876 years) had attended primary school. Overall (current or previous) employment level was also low. Obesity, hypertension and dyslipidaemias were present in most patients, diabetes in 17.3% of them. In all 8.0% of hypertensives, 16.1% of diabetics and 24.7% of dyslipidaemics were unaware of their diseases. Cardiovascular risk profile was worse at lower educational and employment levels. Odds ratios for the metabolic syndrome were 0.28 (95% confidence interval (CI) ¼ 0.15-0.52) and 0.35 (0.20-0.62) in the most qualified of three education and employment groups, respectively, compared to the lowest ones. The level of all cardiovascular RFs was effectively reduced during treatment. Control rate of most RFs improved significantly (for hypertension, from 12.8 to 36.5%, Po0.001). These patients had a high prevalence of cardiovascular RFs, which correlated with their educational and work activity levels. Awareness of their health status was unsatisfactory. Treatment, specifically addressing patient-physician relationship, favourably affected cardiovascular risk profile.

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Social isolation and outcomes post stroke

Abstract: Prestroke social isolation is a predictor of outcome events post stroke. Lack of social support may contribute to poorer outcomes due to poor compliance, depression, and stress.

Cited by 259 publications

References 29 publications

Improving Well-Being in Caregivers of Terminally Ill Patients. Making the Case for Patient Suffering as a Focus for Intervention Research

Improving Well-Being in Caregivers of Terminally Ill Patients. Making the Case for Patient Suffering as a Focus for Intervention Research

What Factors Predict Who Will Have a Strong Social Network Following a Stroke?

Improvement of cardiovascular risk profile in an elderly population of low social level: the ICON (Improving Cardiovascular risk profile in Older Neapolitans) study

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