Supporting Family Caregivers in Stroke Care

Abstract

Background and Purpose-Teaching effective problem-solving skills to family caregivers of patients with chronic disease has been shown to be useful for promoting physical and psychosocial well-being. However, the use and effectiveness of problem solving for supporting caregivers in stroke care has not been reviewed. This article aims to identify and review studies that have examined the effectiveness of teaching problem solving skills to caregivers in stroke care, highlight gaps in the evidence base, and recommend avenues for additional research. Methods-A structured review of literature identified from nursing, medicine, and psychology databases from 1970 to 2004 was conducted. Eleven articles reporting the development or evaluation of effective problem-solving interventions for caregivers of patients with stroke were critically appraised using recognized quality criteria. Results-The results of this review show that the strength of evidence for problem-solving interventions for caregivers of stroke patients is limited. Because some studies used small samples and varied methods and interventions, making a comparison was difficult. Caregivers' problem-solving abilities were rarely measured, and the theoretical concepts and framework underpinning most studies were unclear. Conclusions-Evidence from the review suggests a need to additionally study the link between theoretical concepts of effective problem solving and outcomes using standardized measures and to examine also the processes involved in implementing the intervention using multimethod designs, including both quantitative and qualitative approaches.

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

“…Following title and abstract screening, 18 full-text reports were reviewed and seven syntheses were included in the meta-review. [64][65][66][67][68][69][70] Across all the LTCs examined, the qualitative systematic reviews often failed to comment…”

“…70 Some of the primary qualitative studies were included in more than one review (Table 12), but there were 130 unique qualitative studies included in the reviews overall.…”

“…64,65,67,69 The second was based on reviews examining people's views of services offered to those who had experienced a stroke, investigating challenges faced and potential solutions found. [65][66][67][68]70 Four reviews focused on the experiences of stroke survivors, 64,[67][68][69] and three included both stroke survivors and others involved in their lives, such as caregivers, family and friends. 65,66,70 Most reviews carried out syntheses using extraction matrices, with only three describing their analytical approach (clustering technique, 66 meta-summary, 67 and meta-synthesis and lines-of-argument synthesis with a meta-ethnographic approach 68 ).…”

“…More weight was applied to the results of the four papers that scored highly (30+) during the quality assessment, 64,66,68,69 and less weight applied to the three lower (< 30) scoring papers 65,67,70 (Table 14). A high level of data saturation emerged around the arising themes, suggesting similar experiences being discussed in the majority of qualitative studies.…”

Caregiver strain and quality of life 6 - 36 Months post stroke

“…This help comes from caregivers who are largely untrained (informal caregivers). The caregivers play an important role in facilitating participation of the patient in their daily functional ability, main taining functional improvements gained in rehabilitation and the long term after the stroke (Berg et al 2005;Lui et al 2005;Visser Meily et al 2005).…”