Social work support and unmet social needs in life after stroke: a cross-sectional exploratory study

Abstract

Background: Stroke patients are often affected by long-term disabilities with needs concerning social issues. There is relatively little consideration of social recovery of patients and the support required to return to work, receive social benefits, participate in daily life activities, maintain contact with family and friends and to organize financial affairs. In our study we aimed to investigate if existing tools record social needs adequately. We analyzed the current provision of social support provided in long-term care after stroke and whether unmet social needs were associated with quality of life, caregiver burden, overall function and degree of disability. Methods: Our analysis is part of the Managing Aftercare of Stroke study (MAS-I), a cross-sectional exploratory study of patient needs 2-3 years after initial stroke. Assessment tools included the Nikolaus-score (social situation), the EuroQoL (quality of life), the German Burden Scale for Family Caregivers (caregiver burden), the modified Rankin Scale (disability / dependence), Stroke Impact Scale (function and degree of disability) and the Stroke Survivor Needs Questionnaire (unmet needs). Results: Overall 57 patients were included in MAS-I, with ten patients classified in urgent need of socio-economic support according to the Nikolaus-score. Patients with lower than normal Nikolaus-score had a higher degree of disability. Thirty percent of all patients had never received professional social support. Social worker contact happened mostly during the stay in acute hospital or rehabilitation institution. Only four patients (11%) reported long-term support after discharge. Apart from social worker contact during acute care, 43% of patients had unmet needs in the long-term aftercare. Forty percent of all patients included in MAS-I were recommended for social work intervention after an in-depth analysis of their situation. Finally, we saw that unmet social needs were associated with lower quality of life and higher caregiver burden. Conclusions: Our data suggest significant unmet needs in social care in long-term stroke patients. Screening tools for unmet social needs such as the Nikolaus-score do not holistically report patients’ needs.

The Influence of Neurological Rehabilitation on Patients’ Quality of Life After Ischemic Stroke: A Prospective Study in Romania

“…All patients living with at least one relative had significantly higher SSQOL indices than those living alone or in nursing homes. Our research data are similar to the results of a study conducted in Portugal and Luxembourg that demonstrated a strong correlation between patient satisfaction and family integration in aphasia rehabilitation therapy [49] as well as other works [59][60][61][62].…”

Cuidadores Familiares Dos Sobreviventes De Acidente Vascular Cerebral: Sobrecarga E Fatores Relacionados

“…Este é um cenário comum entre os cuidadores e o suporte de um assistente social seria fundamental para orientar sobre a busca de recursos sociais na rede assistencial, como o auxílio nanceiro, empréstimo ou doação de produtos (i.e., cadeira de rodas, camas, alimentação), entre outros. Este suporte social informativo pode contribuir para reduzir a sobrecarga e melhorar a qualidade de vida dos cuidadores familiares (26) .…”

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“…Consequently, this suggests their usefulness as an indicator of the quality of life of stroke patients. In studies carried out by Khalid et al [12] the majority of patients were people with ischemic stroke (76.8%) with an age median of 59 (17) years. The time median since stroke was 13.83 months.…”

“…A significantly greater number of patients with PTSD had depression (P < 0.001) and anxiety (P < 0.001) compared to patients without PTSD. In turn, Lehnerer et al [17] assessed their current offer of social support provided in long-term post-stroke care and the incidence of unmet social needs in the long term. They also determined whether these unmet needs were related to quality of life, caregiver burden, overall function and degree of disability, and stroke scale.…”