Structured Nursing Intervention Versus Routine Rehabilitation After Stroke

Nir, Z.; Zolotogorsky, Zoly; Sugarman, Heidi

doi:10.1097/01.phm.0000130026.12790.20

Cited by 49 publications

(52 citation statements)

References 20 publications

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“…16 Although therapists support functional recovery, 2 nurses and SW play an important role in identifying social and emotional challenges and supporting patients as they recover from stroke. [17][18][19] Social care has been identified as a particular challenge in securing timely discharge to ESD, 20 which further highlights the importance of the inclusion of nurses and social workers in interprofessional ESD teams. Based on the results of this review, it would be our recommendation that PT, OT, SLP, SW, and nursing be considered as critical components of an effective ESD team.…”

Section: Discussionmentioning

confidence: 99%

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Meyer

Teasell

Thind

et al. 2016

Can. J. Neurol. Sci.

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This review aimed to summarize data from peer-reviewed studies of team-coordinated and delivered early supported discharge (ESD) for postacute, poststroke rehabilitation. A systematic review was performed in Medline, Embase, and CINAHL for appropriate studies. Information on program details and patient cohorts was synthesized. All programs sought patients with mild-to-moderate functional impairment and minimal cognitive impairment (often based on Barthel Index and Mini-Mental State Examination scores, respectively). All also included at least one subjective admission criterion related to rehabilitation suitability or the suitability of the home environment. Based on the identified studies, ESD programs can assume that 15% of patients screened for ESD will be eligible and care should be provided for 4 to 5 weeks postdischarge. Although the benefits of team-coordinated and delivered ESD poststroke have been well-documented, this review may be helpful for clinicians, administrators, and policy makers looking to establish or refine an ESD program for stroke.RÉSUMÉ: Synthèse de la littérature revue par des pairs sur le congé hospitalier précoce avec soutien coordonné et fourni par une équipe de personnel soignant après un accident vasculaire cérébral. L'objectif de cette revue était de résumer les données des études revues par des pairs sur le congé hospitalier précoce avec soutien (CHPS) coordonné et fourni par une équipe de personnel soignant pour la réadaptation post aiguë après un accident vasculaire cérébral (AVC). Nous avons effectué une revue systématique dans les bases de données Medline, Embase et CINAHL pour identifier les études pertinentes. Nous avons effectué une synthèse de l'information sur les détails des programmes et sur les cohortes de patients. Tous les programmes visaient des patients ayant un déficit fonctionnel de léger à modéré et un déficit cognitif minime (souvent basé sur le score à l'indice de Barthel et au Mini-Mental State Examination respectivement). Tous incluaient également au moins un critère d'admission subjectif en lien avec l'adéquation du sujet et de son environnement domiciliaire à la réadaptation. D'après les études identifiées, les programmes de CHPS peuvent présumer que 15% des patients dépistés pour un CHPS y seront éligibles et que les soins devraient être prodigués pendant 4 à 5 semaines après le congé. Bien que les bénéfices du soutien coordonné et fourni par une équipe de personnel soignant après un CHPS aient été bien documentés, cette revue peut aider les cliniciens, les administrateurs et les décideurs qui prévoient établir ou perfectionner un tel programme pour l'AVC.

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Section: Discussionmentioning

confidence: 99%

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Meyer

Teasell

Thind

et al. 2016

Can. J. Neurol. Sci.

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“…Although several studies each reported on more than one stroke risk factor, nine interventions had a focus on self-management for lifestyle behaviours in general [31-35, 38-40, 43], two interventions had a specific focus on self-management for physical activity [42][43][44], two interventions had a focus on blood pressure [36,41], and one on medication adherence [37].…”

Section: Resultsmentioning

confidence: 99%

“…In seven studies, the interventions were administered in-person [32, 34, 36-37, 40, 43-44], six on an individual basis [34, 36-37, [43][44][45], one using a group format [32], and one using both individual and group formats [40]. Three studies delivered the intervention via telehealth, using a telephone [33,38] [41][42]).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients

2016

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Purpose-The aim of this review was to describe the self-management interventions used to improve risk factor control in stroke patients, and quantitatively assess their effects on: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose); and 2) individual risk factors (e.g. physical activity, blood pressure, cholesterol).Methods-We systematically searched the PubMed, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The selfmanagement interventions were qualitatively described, and the data included in meta-analyses.Results-Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low quality studies were removed (SMD = 0.10 [95% CI = 0.02 to 0.17], I 2 = 0%, p=0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95% CI = 0.04 to 0.25], I 2 = 0%, p=0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95% CI = 0.07 to 0.56], I 2 = 0%, p=0.01).Conclusions-Self-management interventions appear to be effective at improving overall risk factor control, however, more high quality research is needed to corroborate this observation. SelfCorresponding author: Janice J. Eng, PhD, BSc(PT/OT), Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Tel: 604-714-4108; Fax: 604-714-4168; janice.eng@ubc.ca. Compliance with Ethical StandardsConflict of Interest: BMS declares that he has no conflict of interest. AJK declares that she has no conflict of interest. JJE declares that she has no conflict of interest. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all individual participants included in the study.

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“…Assessing individual needs, responding to patients as individuals and engaging with those close to them may be especially difficult when patients are unable to engage in normal social interactions and about whom nursing staff may have little or no prior knowledge (Rogers & Addington-Hall 2005). Such patients are easily forgotten in busy acute environments, where the focus of specialist stroke care tends to be on rehabilitation and recovery (Coleman Gross et al 2001, Hilderley et al 2002, Nir et al 2004.…”

Section: Stroke Care At the End Of Lifementioning

confidence: 99%

Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire

Young

Rogers

Dent

et al. 2009

Journal of Advanced Nursing

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Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire. Journal of Advanced Nursing 65(10), 2161-2174. doi: 10.1111/j.1365-2648.2009.05081.x Abstract Title. Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire. Aim. This paper is a report of a study conducted to explore the determinants of satisfaction with health and social care services in the last 3 months and 3 days of life as reported by bereaved relatives of those who died from a stroke in an institutional setting. Background. There is limited research about how best to meet the needs of those who die from stroke. A thorough understanding of the determinants of satisfaction with end of life care is crucial for effective service provision to increase awareness of the needs of dying patients. Methods. During a six-month period in 2003, a population-based survey of bereaved relatives of patients after stroke was conducted using a stroke-specific version of the Views of Informal Carers Evaluation of Services postal questionnaire (183 informants, response rate 37%). The sub-sample included those informants who reported that the deceased person had died in an institutional setting (91%, n = 165). The analysis was divided into two phases: univariate (Pearson chi-square test) and multivariate phase (logistic regression). Results. Logistic regressions showed that discussing any worries about the treatment of the deceased person and feeling that the doctors and nurses knew enough about their condition were predictors of satisfaction with doctors and nurses in the last 3 months of life. Meeting the personal care needs of the deceased person, being involved in decisions and feeling that the deceased person died in the right place were predictors of satisfaction with care in the last 3 days of life. Conclusion. End of life care needs to address the individual needs of patients who die from stroke and those close to them. This study shows that individualised end of life care increases satisfaction and, although the data reported in this paper reflect care in 2003, there is no more recent evidence that contradicts this important overall finding.

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Structured Nursing Intervention Versus Routine Rehabilitation After Stroke

Cited by 49 publications

References 20 publications

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients

Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire

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