The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups

Pound, Carole; Greenwood, Nan

doi:10.3109/09638288.2015.1107783

Cited by 14 publications

(40 citation statements)

References 52 publications

(57 reference statements)

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“…What they perceived as important was that the therapeutic interactions made them feel “human,” valued, and noticed as people. Others have argued that, through embracing frameworks such as the humanizing values framework ( Galvin & Todres, 2012 ), stroke care may become more person-centered and holistic ( Pound & Greenwood, 2016 ), enabling health care workers to accord value to interactions that may make a profound difference to their patients, but do not necessarily lead to easy-to-measure change.…”

Section: Discussionmentioning

confidence: 99%

“Now I Am Myself”: Exploring How People With Poststroke Aphasia Experienced Solution-Focused Brief Therapy Within the SOFIA Trial

et al. 2021

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Aphasia, a language disability, can profoundly affect a person’s mood and identity. The experiences of participants who received Solution-Focused Brief Therapy, a psychological intervention, were explored in the Solution-Focused brief therapy In poststroke Aphasia (SOFIA) Trial. Thirty participants with chronic aphasia, 14 with severe aphasia, participated in in-depth interviews that were analyzed using framework analysis. Two overarching themes emerged: valued therapy components (exploring hopes, noticing achievements, companionship, sharing feelings, and relationship with therapist) and perceptions of progress (mood, identity, communication, relationships, and independence). Participants were categorized into four groups: (a) “changed,” where therapy had a meaningful impact on a person’s life; (b) “connected,” where therapy was valued primarily for companionship; (c) “complemental,” where therapy complemented a participant’s upward trajectory; and (d) “discordant,” where therapy misaligned with participants’ preference for impairment-based language work. This study suggests that it is feasible to adapt a psychological therapy for people with aphasia, who perceive it as valuable.

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Section: Discussionmentioning

confidence: 99%

“Now I Am Myself”: Exploring How People With Poststroke Aphasia Experienced Solution-Focused Brief Therapy Within the SOFIA Trial

et al. 2021

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“…The humanizing values framework describes eight philosophically informed dimensions (e.g., ‘uniqueness versus homogenisation’; ‘sense making versus loss of meaning’; ‘agency versus passivity’; ‘togetherness versus isolation’), which it has been argued can inform nurse education (Scammell et al . ) and understanding stroke care (Pound and Greenwood ). Such a framework may also be useful in SLT education and practice, placing what it means to be human at the heart of all SLT interactions.…”

Section: Discussionmentioning

confidence: 99%

“…The humanizing values framework has been suggested as one way of enabling healthcare professionals to provide person-centred care despite the pressure of the system, through placing value on the 'things that make us feel more human' (Galvin and Todres 2012). The humanizing values framework describes eight philosophically informed dimensions (e.g., 'uniqueness versus homogenisation'; 'sense making versus loss of meaning'; 'agency versus passivity'; 'togetherness versus isolation'), which it has been argued can inform nurse education (Scammell et al 2012) and understanding stroke care (Pound and Greenwood 2016). Such a framework may also be useful in SLT education and practice, placing what it means to be human at the heart of all SLT interactions.…”

Section: Future Directions and Implicationsmentioning

confidence: 99%

Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support

Northcott

Simpson

Moss

et al. 2017

Intl J Lang & Comm Disor

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Background: People with aphasia are at risk of becoming depressed and isolated. Online surveys have found that the majority of speech and language therapists (SLTs) lack confidence in addressing the psychological needs of people with aphasia. Aims: To explore how SLTs conceptualize the scope of their role; barriers and facilitators to SLTs addressing psychosocial needs; and SLTs' experiences of specialist training and support, and working with mental health professionals (MHPs). Methods & Procedures:Focus groups were conducted in stroke healthcare settings. Purposive sampling was used when selecting sites so as to capture a range of experiences. Results were analysed using framework analysis. Outcomes & Results: Twenty-three SLTs took part in six focus groups. Participants' psychosocial work included counselling-type interactions, psycho-education, working with families, facilitating peer support and training other healthcare professionals. There was lack of consensus on the scope of the SLT role. Many expressed a sense of conflict, both perceiving it as valuable to spend time addressing psychological well-being, while simultaneously feeling uneasy if they deviated from 'direct SLT' work. Barriers to addressing psychosocial well-being were: emotionally challenging nature of this work, particularly for those who felt unsupported; caseload and time pressures; attitudes of senior managers and commissioners; difficulties measuring and documenting more 'fluid' psychosocial work; and the complexity of the needs and backgrounds of some patients. Enabling factors were: specialist ongoing support; peer support from colleagues; experience; support of management; and personal belief. Specialist training was valued. It changed how participants viewed the therapist-client relationship (more client led); the assessment and goal-setting process; and gave them more confidence to acknowledge client emotions. However, many felt that there was a need for ongoing specialist advice, and to be able to see approaches modelled for this client group. In terms of MHPs, a subset of stroke-specialist clinical psychologists worked directly with people with marked aphasia and families, as well as supporting the multidisciplinary team to provide holistic care. However, a main theme was that participants perceived many MHPs did not consider people with aphasia as 'appropriate candidates' for psychological input. Conclusions & Implications:All participants cared about the emotional well-being of their clients; however, they identified a number of barriers to people with aphasia receiving appropriate psychological support. A cultural shift, whereby psychological care for people with aphasia is seen as valuable, feasible and necessary, delivered collaboratively by SLTs, MHPs and the wider team, may improve services.

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“…Key considerations for policy and practice include the health and care profile of older carers, with many being both provider and recipient of care (Carers UK, 2016;Carers Trust, 2019); the 'reversed' gender profile of carers aged eighty-five or over, with three out of five being male; and the increasing number of older carers from black, Asian and minority ethnic (BAME) communities (Carers UK, 2016; see also Dahlberg et al, 2007;Pound and Greenwood, 2016).…”

Section: Olde R Carersmentioning

confidence: 99%

Supporting Older Co-Resident Carers of Older People – The Impact of Care Act Implementation in Four Local Authorities in England

O’Rourke

Lloyd

Bezzina

et al. 2020

Social Policy and Society

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The Care Act 2014 provides for ‘parity of esteem’ between people with social care needs and carers. This is achieved by extending the principles of prevention and wellbeing to carers; reinforcing carers’ right to an assessment; and setting national eligibility criteria for access to carer support services. This article reports on research that examined the impact of these changes on older co-resident carers of older people in four English local authorities. Findings are described in relation to four key themes: organisational arrangements and rationale; the aims of carer support and preventative services; design and delivery of carer assessment; and barriers to assessment and support. The findings of the research suggest that, despite the new statutory requirements, underlying contradictions and tensions in local authorities’ relationship with carers, and efforts to support them, remain unresolved.

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The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups

Cited by 14 publications

References 52 publications

“Now I Am Myself”: Exploring How People With Poststroke Aphasia Experienced Solution-Focused Brief Therapy Within the SOFIA Trial

“Now I Am Myself”: Exploring How People With Poststroke Aphasia Experienced Solution-Focused Brief Therapy Within the SOFIA Trial

Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support

Supporting Older Co-Resident Carers of Older People – The Impact of Care Act Implementation in Four Local Authorities in England

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