Social participation of relatives post-stroke: the role of rehabilitation and related ethical issues

Pellerin, Caroline; Rochette, Annie; Racine, Éric

doi:10.3109/09638288.2010.524272

Cited by 39 publications

(32 citation statements)

References 25 publications

(78 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 Caregivers experience restricted or missed valued social activities, such as performing family rituals, visiting family and friends, attending religious services, participating in social events or classes, and going out for enjoyment. 6,10 Many restrictions are for a limited time, but caregivers report a loss of friends because of inadequate social contact with these friends. 2 Therefore, nurses should assist caregivers to identify strategies for maintaining these contacts, both separately and together with the stroke survivor (adapting activities around stroke survivors' deficits).…”

Section: Interpersonal Issues and Nursing Interventionsmentioning

confidence: 99%

“…[6][7][8] Empirical literature also indicates that caregivers feel uncertain and unprepared in the caregiving role. 9 Caregivers need open and honest communication about their role and stroke survivors' abilities, 3,10 while also offering hope. Conducting a comprehensive predischarge nursing assessment of caregiver physical and psychological health and social, financial, and spiritual needs initially and during follow-up is essential.…”

Section: Individual Issues and Nursing Interventionsmentioning

confidence: 99%

“…4 Furthermore, although guidelines exist, some resources suggest there is no consensus about what caregivers need in rehabilitation and the guidelines are not consistently applied in practice. 10 Although caregivers report being invited to observe rehabilitation therapy and care, fewer opportunities may be available to practice these important caregiving skills adequately. 4 Household environments also differ from rehabilitation settings (eg, logistics of bathrooms and hallways), making it difficult to transfer these skills to home settings.…”

mentioning

confidence: 99%

“…8,10 More comprehensive services offered on weekends and during all phases of recovery (eg, acute care, rehabilitation, and after rehabilitation) is important. Realistic simulated environments that better mimic caregivers' homes during rehabilitation also may be valuable in transferring skills to the home setting.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Common Caregiver Issues and Nursing Interventions After a Stroke

Grant

Hunt

Steadman

2014

Stroke

View full text Add to dashboard Cite

A fter rehabilitation, most stroke survivors return to the community and continue with their daily lives, despite stroke-related functional, cognitive, and behavioral changes.1 Caregivers are the primary support system for these survivors after discharge and an integral part of the healthcare team that contributes to survivors' rehabilitation and recovery.2,3 However, caregiving is stressful, and caregivers often experience a variety of interrelated individual, interpersonal, and organizational issues in managing stroke-related deficits. These issues and potential nursing interventions for addressing them will be discussed in this article. Individual Issues and Nursing InterventionsIndividual caregiver issues commonly relate to insufficient knowledge and skills to understand and manage stroke survivors' physical, cognitive, emotional, and behavioral problems. 4 Initially, caregivers request information about the stroke diagnosis, prognosis, complications, and predicted recovery. 5 As stroke survivors begin the transition to home care, caregivers require information about assuring their safety, including fall prevention, medications, and prescriptions; adequate nutrition; and management of physical, instrumental, psychological, and behavioral problems. Empirical data support caregivers who also require information and support about how to manage complex feelings and interactions with stroke survivors who experience memory problems, depression, anxiety, frustration, withdrawal, and are argumentative. [6][7][8] Empirical literature also indicates that caregivers feel uncertain and unprepared in the caregiving role.9 Caregivers need open and honest communication about their role and stroke survivors' abilities, 3,10 while also offering hope. Conducting a comprehensive predischarge nursing assessment of caregiver physical and psychological health and social, financial, and spiritual needs initially and during follow-up is essential. 11This assessment is vital to understand how caregivers' skills, abilities, and resources match stroke survivors' needs for follow-up care better. On the basis of this assessment, nurses should develop a highly individualized case management plan to help caregivers attain skills and services necessary to facilitate success and seamless postdischarge transition. 2Although nurses provide important information, stroke-and caregiving-related information commonly is not remembered by overwhelmed caregivers. Therefore, basic information should be provided throughout acute and chronic care in both oral and written formats, with frequent reinforcement of specific information in the caregiving trajectory.12 Caregivers also request that more extensive services be offered during rehabilitation, especially on weekends 13 because competing work and other responsibilities (family, home, and church) make attending rehabilitation therapy difficult during the week. 4 Furthermore, although guidelines exist, some resources suggest there is no consensus about what caregivers need in rehabilitation and the gu...

show abstract

Section: Interpersonal Issues and Nursing Interventionsmentioning

confidence: 99%

Section: Individual Issues and Nursing Interventionsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Common Caregiver Issues and Nursing Interventions After a Stroke

Grant

Hunt

Steadman

2014

Stroke

View full text Add to dashboard Cite

show abstract

“…For patients living with long-term complex conditions, a large part of their health services might be performed by the patients themselves as self-management or by significant others, as illustrated by Erik’s case (Table 1). A systematic review of the situation of informal caregivers vis-à-vis patients who have had a stroke has shown increased and additional responsibilities for caregivers, leading to decreased time for leisure and paid work [30]. Being an informal caregiver thus may affect the caregiver’s own health [31, 32].…”

Section: Discussionmentioning

confidence: 99%

The case of value-based healthcare for people living with complex long-term conditions

Elf

Flink

Nilsson

et al. 2017

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThere is a trend towards value-based health service, striving to cut costs while generating value for the patient. The overall objective comprises higher-quality health services and improved patient safety and cost efficiency. The approach could align with patient-centred care, as it entails a focus on the patient’s experience of her or his entire cycle of care, including the use of well-defined outcome measurements. Challenges arise when the approach is applied to health services for people living with long-term complex conditions that require support from various healthcare services. The aim of this work is to critically discuss the value-based approach and its implications for patients with long-term complex conditions. Two cases from clinical practice and research form the foundation for our reasoning, illustrating several challenges regarding value-based health services for people living with long-term complex conditions.DiscussionAchieving value-based health services that provide the health outcomes that matter to patients and providing greater patient-centredness will place increased demands on the healthcare system. Patients and their informal caregivers must be included in the development and establishment of outcome measures. The outcome measures must be standardized to allow evaluation of specific conditions at an aggregated level, but they must also be sensitive enough to capture each patient’s individual needs and goals. Healthcare systems that strive to establish value-based services must collaborate beyond the organizational boundaries to create clear patient trajectories in order to avoid fragmentation.SummaryThe shift towards value-based health services has the potential to align healthcare-service delivery with patient-centred care if serious efforts to take the patient’s perspective into account are made. This is especially challenging in fragmented healthcare systems and for patients with long-term- and multi-setting-care needs.

show abstract