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Nichol L, Wallace SJ, Pitt R, Rodriguez AD, Hill AJ. Communication partner perspectives of aphasia self-management and the role of technology: an in-depth qualitative exploration. Disabil Rehabil 2022; 44:7199-7216. [PMID: 34747289 DOI: 10.1080/09638288.2021.1988153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE "Self-management" empowers individuals to take responsibility for their healthcare through skill-building, personal growth, and self-efficacy related to chronic health condition management. Self-management approaches may benefit people with aphasia (PwA); however, PwA are often excluded from stroke self-management research and there is no published research reporting on aphasia-specific self-management programs. Communication partners (CPs) are involved in the rehabilitation and day-to-day lives of PwA, thus giving them unique insights and knowledge of PwA needs. The present study aimed to investigate CP experiences and perspectives regarding aphasia self-management and to explore CP perceptions of the use of technology in aphasia self-management. METHODS In-depth, semi-structured interviews with 14 CPs living in Australia. Interview data was analysed using qualitative content analysis. RESULTS Analysis revealed six core themes: (1) aphasia self-management is embedded into everyday life, (2) CPs provide comprehensive self-management support, (3) speech-language pathologists (SLPs) provide tools and support to enable PwA to self-manage, (4) aphasia self-management can be enhanced by technological supports, (5) potential positive outcomes of aphasia self-management, and (6) factors influencing successful aphasia self-management. CONCLUSIONS Aphasia self-management programs should focus on individual needs, functional communication in daily life, and social interaction. PwA and CPs are central to these programs, assisted by SLPs. Technology should be explored to augment aphasia self-management.Implications for RehabilitationCommunication partners suggest that people with aphasia are already engaging in aspects of self-management and that more formal aphasia-specific self-management approaches may be beneficial.Dedicated aphasia self-management programs should be situated in daily life with a focus on functional communication, life participation, confidence, and independence.Communication partners, speech-language pathologists, and technology are key support sources for aphasia self-management.Further input should be sought from communication partners in the development of aphasia self-management programs.
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Affiliation(s)
- Leana Nichol
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Rachelle Pitt
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia.,West Moreton Health, Ipswich, Australia
| | - Amy D Rodriguez
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, United States
| | - Annie J Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Surgical, Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Brisbane, Australia
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Fujino Y, Fukata K, Inoue M, Okawa S, Okuma K, Kunieda Y, Miki H, Matsuda T, Amimoto K, Makita S, Takahashi H, Fujiwara T. Examination of Rehabilitation Intensity According to Severity of Acute Stroke: A Retrospective Study. J Stroke Cerebrovasc Dis 2021; 30:105994. [PMID: 34284324 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate the intensity and effectiveness of rehabilitation in acute stroke patients according to the severity of functional impairments in them. MATERIALS AND METHODS This retrospective cohort study included 294 patients with acute hemispheric stroke admitted to three acute-care hospitals who subsequently underwent an inpatient rehabilitation program. Stroke severity was classified according to neurological deficits and trunk dysfunction. The following data were obtained from medical records: age, sex, stroke type, lesion side, hospitalization duration, initial functional status determined using the National Institutes of Health Stroke Scale, rehabilitation start date, first day out of bed after admission, total treatment duration, total number of treatment sessions, rehabilitation implementation rate between start of rehabilitation and discharge, trunk control test and Barthel Index score on the first day out of bed after admission and discharge, and post-discharge outcomes. Hierarchical cluster analysis was performed with clusters categorized using the National Institutes of Health Stroke Scale and trunk control test scores. Variables were compared using the Kruskal-Wallis test, and Dunn's nonparametric comparison test was performed for post-hoc analysis to determine differences between clusters. RESULTS The National Institutes of Health Stroke Scale and trunk control test showed a significant correlation (r = -0.816, p < 0.01) using which cluster analysis identified three clusters. Rehabilitation showed a ceiling effect in patients with mild stroke and a floor effect in patients with severe stroke. CONCLUSION These results may guide the determination of rehabilitation intensity with reference to the severity of neurological deficits and trunk dysfunction.
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Affiliation(s)
- Yuji Fujino
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 3-2-12, Hongo Bunkyo-ku, Tokyo, Japan.
| | - Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shinsuke Okawa
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | - Katsunobu Okuma
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | - Yota Kunieda
- Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Hiroshi Miki
- Department of Rehabilitation, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Tadamitsu Matsuda
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 3-2-12, Hongo Bunkyo-ku, Tokyo, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Toshiyuki Fujiwara
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 3-2-12, Hongo Bunkyo-ku, Tokyo, Japan; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan
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D'Cruz K, Meikle L, White M, Herrmann A, McCallum C, Romero L. Tailoring education of adults with cognitive impairment in the inpatient hospital setting: A scoping review. Aust Occup Ther J 2020; 68:90-102. [PMID: 33029784 DOI: 10.1111/1440-1630.12698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Education seeks to empower clients to attain and maintain knowledge and skills, and in the context of occupational therapy, to enable occupational participation. While education is routinely provided in the inpatient hospital setting, little is known about how education is best adapted to meet the needs of clients with cognitive impairment. The purpose of this scoping review was to determine what is currently known about approaches to educating adults with cognitive impairment in the inpatient hospital setting. METHODS Five databases were systematically searched to find studies that reported on the use of education in the inpatient hospital setting with adults with cognitive impairment. RESULTS Ten articles were retrieved from the search with duplication of authors across the articles, indicating a small group of research and researchers. Cognitive impairment was not well assessed across all the studies and none included participants with severe cognitive impairment. A number of barriers to education were identified, including time constraints, uncertainty around who should be providing education, a shortage of resources, and client-related barriers such as cognitive deficits. From the retrieved studies it was found that education should occur at multiple time points, be individually tailored, and utilise mixed modal approaches such as verbal and written methods. There was also a preference for less use of jargon, and engagement with carers and clients where possible. CONCLUSION This scoping review highlights factors impacting the provision of education tailored to the needs of clients with cognitive impairment in the inpatient setting. The findings also call to attention the need for better assessment of cognition to guide provision of tailored education, as well as future studies exploring how to best educate clients with not only mild/moderate cognitive impairment but also more severe impairments.
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Affiliation(s)
- Kate D'Cruz
- Discipline of Occupational Therapy, La Trobe University, Melbourne, Vic, Australia
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4
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Cardinal LA, Freeman-Sanderson A, Togher L. The speech pathology workforce in intensive care units: Results from a national survey. Aust Crit Care 2020; 33:250-258. [PMID: 32386794 DOI: 10.1016/j.aucc.2020.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Admission to the intensive care unit (ICU) with mechanical ventilation can lead to patients experiencing impaired swallowing and communication function. This can negatively affect patient experiences and outcomes. There is increasing research supporting early intervention for swallowing and communication; however, there are no published ICU workforce data to determine patient access. PURPOSE The purpose of this study was to describe national ICU access to speech pathology (SP) services and to describe the nature of this workforce. METHODS Prospective audit of Australian ICUs with a focussed workforce survey of SP service including workforce demographics, clinical practices, team environments, and training was conducted. Data are described as percentage (%, n) and as median (interquartile range). Qualitative data were analysed using thematic frameworks. RESULTS SP services were available at 99% (n = 165) of the sites; 62 sites provided workforce data (45% response rate). Seventy-one percent of respondents serviced the ICU ≤10 h per week, with 23% reporting dedicated funding. Almost a third (32%) reported not participating in ICU team activities, and more than half of the sites (56%) did not provide ICU-specific training with resulting varied clinical confidence ratings. Facilitator and barriers both highlighted team working relationships. Facilitator themes were building working relationships, understanding the SP role in the multidisciplinary team, physical presence in the unit, and access to resources. Barrier themes were the multidisciplinary team's understanding of SP roles and lack of presence of SP services in the ICU. CONCLUSIONS SP services are not standard across Australian ICUs, with variations in confidence, funding, training, and team environments. Further research into the impact of these variations on patient outcomes is needed.
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Affiliation(s)
- Lara Anne Cardinal
- The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Amy Freeman-Sanderson
- University of Technology Sydney, PO Box 123 Broadway, Ultimo, NSW, 2007, Australia; The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Leanne Togher
- The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
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Hodson T, Gustafsson L, Cornwell P. "Just got to live life as it comes": A case study of the spousal-dyad longitudinal mild stroke transitional experience. Brain Inj 2019; 33:1200-1207. [PMID: 31216900 DOI: 10.1080/02699052.2019.1629625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To longitudinally explore the transition home for a spousal dyad following mild stroke, in the context of a mild stroke-specific health service. Research Design: A case study approach, using an Interpretative Phenomenological Analysis (IPA), was identified as suitable for this study, as it enabled the essence of the phenomenon to be examined. Method: Participants were purposively chosen from a Randomised Control Trial (RCT), to reflect the average age, gender and marital status of the mild stroke population. The participants were a male (age 64) and his wife (age 62). Participants received the RCT intervention. Semi-structured interviews were completed separately with participants at 1-, 3-, 6- and 9- months post stroke. Results: Two themes were identified: (1) The Unexpected, Undesirable and Short-Lived, and (2) The New 'Normal'. The first theme reflects the confusion, adjustment and adaptation that occurred for the couple, especially during the first month at home. The second represents the couple's journey back to their everyday lives following hospital discharge, but also the questions and changes that remained present at 9-months post-discharge. Conclusions: Themes demonstrate an ongoing process of adjustment and the contextual nature of the transitional experience. Results also indicate the need to ensure that individuals have access to mild-stroke specific information across the transition continuum.
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Affiliation(s)
- Tenelle Hodson
- a School of Health and Rehabilitation Sciences, The University of Queensland , Queensland , Australia
| | - Louise Gustafsson
- a School of Health and Rehabilitation Sciences, The University of Queensland , Queensland , Australia.,b School of Allied Health Sciences, Griffith University , Brisbane , Australia
| | - Petrea Cornwell
- b School of Allied Health Sciences, Griffith University , Brisbane , Australia
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Tang EYH, Price C, Stephan BCM, Robinson L, Exley C. Gaps in care for patients with memory deficits after stroke: views of healthcare providers. BMC Health Serv Res 2017; 17:634. [PMID: 28886738 PMCID: PMC5591549 DOI: 10.1186/s12913-017-2569-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/25/2017] [Indexed: 11/14/2022] Open
Abstract
Background Stroke is a common cause of physical disability but is also strongly associated with cognitive impairment and a risk for future dementia. Despite national clinical guidelines, the service provided for stroke survivors with cognitive and memory difficulties varies across localities. This study critically evaluated the views of healthcare professionals about barriers and facilitators to their care. Methods Seventeen semi-structured individual interviews were conducted by a single interviewer with both primary and secondary care clinicians in regular contact with stroke-survivors. This included stroke medicine specialists, specialist nurses, physiotherapists, occupational therapists, general practitioners and primary care nurses. Topics included individual experiences of the current care offered to patients with cognitive impairment, assessment processes and inter-professional communication. Interviews were audio recorded and transcribed verbatim. Transcripts were thematically analysed and themes grouped into broad categories to facilitate interpretation. Results Data analysis identified four key themes as barriers to optimal care for stroke-survivors with memory difficulties: 1) Less focus on memory and cognition in post-stroke care; 2) Difficulties bringing up memory and cognitive problems post-stroke; 3) Lack of clarity in current services; and, 4) Assumptions made by healthcare professionals introducing gaps in care. Facilitators included stronger links between primary and secondary care in addition to information provision at all stages of care. Conclusions The care provided by stroke services is dominated by physical impairments. Clinicians are unsure who should take responsibility for follow-up of patients with cognitive problems. This is made even more difficult by the lack of experience in assessment and stigma surrounding potential diagnoses associated with these deficits. Service development should focus on increased cohesiveness between hospital and community care to create a clear care pathway for post-stroke cognitive impairment.
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Affiliation(s)
- Eugene Yee Hing Tang
- Institute of Health and Society and Newcastle University Institute for Ageing, Newcastle University, Level 2, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
| | - Christopher Price
- Institute of Neuroscience, Stroke Research Group, Newcastle University, Newcastle upon Tyne, UK
| | - Blossom Christa Maree Stephan
- Institute of Health and Society and Newcastle University Institute for Ageing, Newcastle University, Level 2, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Louise Robinson
- Institute of Health and Society and Newcastle University Institute for Ageing, Newcastle University, Level 2, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Catherine Exley
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Faux SG, Arora P, Shiner CT, Thompson-Butel AG, Klein LA. Rehabilitation and education are underutilized for mild stroke and TIA sufferers. Disabil Rehabil 2017; 40:1480-1484. [DOI: 10.1080/09638288.2017.1295473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Steven G. Faux
- Department of Rehabilitation Medicine, St Vincent’s Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Pooja Arora
- Department of Rehabilitation Medicine, St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Christine T. Shiner
- Department of Rehabilitation Medicine, St Vincent’s Hospital, Sydney, New South Wales, Australia
| | | | - Linda A. Klein
- Sydney Medical School, University of Sydney, New South Wales, Australia
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8
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Piccenna L, Lannin NA, Gruen R, Pattuwage L, Bragge P. The experience of discharge for patients with an acquired brain injury from the inpatient to the community setting: A qualitative review. Brain Inj 2016; 30:241-51. [DOI: 10.3109/02699052.2015.1113569] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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9
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Eames S, Hoffmann T, Worrall L, Read S. Stroke Patients’ and Carers’ Perception of Barriers to Accessing Stroke Information. Top Stroke Rehabil 2015; 17:69-78. [DOI: 10.1310/tsr1702-69] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Rose T, Worrall L, Hickson L, Hoffmann T. Do People With Aphasia Want Written Stroke and Aphasia Information? A Verbal Survey Exploring Preferences for When and How to Provide Stroke and Aphasia Information. Top Stroke Rehabil 2015; 17:79-98. [DOI: 10.1310/tsr1702-79] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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11
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Eames S, Hoffmann T, McKenna K, Worrall L. Community-Based Stroke Information for Clients with Stroke and Their Carers: Is There Congruency Between Actual and Recommended Practice? Top Stroke Rehabil 2015; 15:295-306. [DOI: 10.1310/tsr1504-295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Short J, McCormack J, Copley A. The current practices of speech-language pathologists in providing information to clients with traumatic brain injury. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:219-230. [PMID: 24588453 DOI: 10.3109/17549507.2014.882413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The provision of information about cognitive-communication disorders (CCDs) following traumatic brain injury (TBI) is important given the impact these communication impairments can have on the rehabilitation of people with TBI. This study describes the results of an online survey which investigated the current practices of 74 Australian speech-language pathologists (SLPs) working with adults with TBI. Thirty-seven SLPs outlined their practices in information provision. SLPs reported they provide information to adults with TBI about CCDs, the impact of CCDs on participation in life activities, and rehabilitation from CCDs. In addition, SLPs identified barriers and facilitators to information provision. Barriers identified included time, impairments resulting from TBI, and personal characteristics of the client. Facilitators included family functioning and support and the multidisciplinary team. Findings of this research indicate a need for some changes in the format and content of information that SLPs provide to adults with TBI, to ensure they can achieve fundamental levels of health literacy and better health outcomes.
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Liu CJ, Pape S, Ferrell J, Turner E, Johanningsmeier K. Gerontic Occupational Therapy and Patient Education: Perceptions, Barriers, and Needs. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2013. [DOI: 10.3109/02703181.2013.782383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Luo G. Open issues in intelligent personal health record--an updated status report for 2012. J Med Syst 2013; 37:9943. [PMID: 23584758 DOI: 10.1007/s10916-013-9943-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/20/2013] [Indexed: 12/16/2022]
Abstract
To improve the capability and usability of the personal health record (PHR) as a tool to empower consumers in the management of their own health, we have proposed the concept of an intelligent PHR (iPHR) and built a prototype iPHR system with four functions. These four functions use various health knowledge and computer science techniques to automatically provide users with personalized healthcare information to facilitate their well-being. This paper discusses several open issues in iPHR, including two enhancements to an existing function and two potential new functions. The two enhancements are for automatically compiling relevant self-care activities for each health issue and automatically identifying contraindicated self-care activities, respectively. One potential new function is personalized search for individual healthcare providers. Another potential new function is personalized local search for health-related services to help maintain patients in their homes. We include some preliminary thoughts on how to address these open issues with the hope to stimulate future research work on iPHR.
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Affiliation(s)
- Gang Luo
- Department of Biomedical Informatics, University of Utah, HSEB Room 5725B, 26 South 2000 East, Salt Lake City, UT, 84112, USA,
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Hoffmann T, Ladner Y. Assessing the suitability of written stroke materials: an evaluation of the interrater reliability of the suitability assessment of materials (SAM) checklist. Top Stroke Rehabil 2012; 19:417-22. [PMID: 22982829 DOI: 10.1310/tsr1905-417] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Written materials are frequently used to provide education to stroke patients and their carers. However, poor quality materials are a barrier to effective information provision. A quick and reliable method of evaluating material quality is needed. This study evaluated the interrater reliability of the Suitability Assessment of Materials (SAM) checklist in a sample of written stroke education materials. METHODS Two independent raters evaluated the materials (n = 25) using the SAM, and ratings were analyzed to reveal total percentage agreements and weighted kappa values for individual items and overall SAM rating. RESULTS The majority of the individual SAM items had high interrater reliability, with 17 of the 22 items achieving substantial, almost perfect, or perfect weighted kappa value scores. The overall SAM rating achieved a weighted kappa value of 0.60, with a percentage total agreement of 96%. CONCLUSION Health care professionals should evaluate the content and design characteristics of written education materials before using them with patients. A tool such as the SAM checklist can be used; however, raters should exercise caution when interpreting results from items with more subjective scoring criteria. Refinements to the scoring criteria for these items are recommended. The value of the SAM is that it can be used to identify specific elements that should be modified before education materials are provided to patients.
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Affiliation(s)
- Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Bower K, Gustafsson L, Hoffmann T, Barker R. Self-Management of Upper Limb Recovery after Stroke: How Effectively Do Occupational Therapists and Physiotherapists Train Clients and Carers? Br J Occup Ther 2012. [DOI: 10.4276/030802212x13336366278130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: A self-management approach to upper limb management following stroke has received little attention in the literature. The aim of the study was to investigate the impact of occupational therapists' and physiotherapists' standard practice on clients' and carers' self-management of upper limb recovery. Method: Fifteen clients, 7 carers, 11 occupational therapists and 7 physiotherapists were recruited. Therapists described five self-administered tasks they expected clients and carers were doing, using the Goal Attainment Scale (GAS). For each task, clients' and carers' performances were then evaluated using the GAS and their self-efficacy was rated on a 10-point Likert scale. A survey questionnaire investigated their perceptions of the training provided, with respect to a self-management approach. Results: At least a quarter of the self-administered tasks related to upper limb activity, strengthening and secondary prevention were performed below therapists' expectations. In contrast, mean self-efficacy ratings across these tasks were high (clients = 7.8–9.5, carers = 8.5–8.9). Seventy per cent of the self-management training strategies listed in the survey questionnaire were considered missing by more than 40% of carers. Conclusion: There is a need for therapy resources that enhance the content and delivery of self-management training related to upper limb management following stroke, particularly for carers.
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Affiliation(s)
- Kylie Bower
- Advanced Team Leader Occupational Therapist, Aged Care Rehabilitation Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia, and PhD candidate, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- Senior Lecturer, Division of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Tammy Hoffmann
- Associate Professor of Clinical Epidemiology, Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ruth Barker
- Adjunct Lecturer, Discipline of Physiotherapy, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
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Hafsteinsdóttir TB, Vergunst M, Lindeman E, Schuurmans M. Educational needs of patients with a stroke and their caregivers: a systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2011; 85:14-25. [PMID: 20869189 DOI: 10.1016/j.pec.2010.07.046] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 07/28/2010] [Accepted: 07/29/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To systematically review the research on stroke patients' and caregivers' educational needs. METHODS A search of the literature prior to and including the year January 2009 was conducted using Medline, CINAHL, EMBASE, PsychINFO and the Cochrane Library, yielding 959 articles. Of these, 21 studies were included in the review. RESULTS Stroke patients and caregivers reported many and diverse educational needs, which often were not met. The educational needs of stroke patients and caregivers concerned knowledge about the clinical aspects of stroke, prevention, treatment and functional recovery. The most commonly reported needs of caregivers involved patients' moving and lifting, exercises, psychological changes and nutritional issues. Patients and caregivers wanted information that was tailored to their situation. CONCLUSION Patients and caregivers have many unmet educational needs. The findings call for improved education of patients and caregivers on various issues that are specific to the various recovery phases after stroke. PRACTICE IMPLICATIONS The findings of this review can be used to develop educational interventions for stroke patients and caregivers. Further research is needed to investigate the feasibility and effects of educational interventions and whether they meet the educational needs of patients and caregivers.
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Affiliation(s)
- Thóra B Hafsteinsdóttir
- Department of Rehabilitation, Nursing Science and Sport medicine, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands.
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Rose TA, Worrall LE, Hickson LM, Hoffmann TC. Aphasia friendly written health information: content and design characteristics. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011; 13:335-347. [PMID: 21682542 DOI: 10.3109/17549507.2011.560396] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
People with aphasia need communicatively accessible written health information. Healthcare providers require knowledge of how to develop printed education materials (PEMs) in formats that people with aphasia prefer and can read. This study aimed to explore formatting characteristics considered to be barriers and facilitators to reading PEMs. Semi-structured in-depth interviews were conducted with 40 adults with aphasia who were selected using maximum variation sampling across aphasia severity, reading ability, and time post-stroke. Participants were shown stroke and aphasia PEMs obtained from the recruiting stroke services, asked to rank them from most liked to least liked, and comment on factors that made the PEMs easier and harder to read. The majority of participants ranked the aphasia friendly stroke (56.4%, n = 22) and aphasia (87.2%, n = 34) PEMs as most liked. Forty-five facilitator and 46 barrier codes were identified using qualitative content analysis and grouped into two categories; (1) content characteristics and (2) design characteristics. Findings support many of the recommendations found within the literature for developing best practice PEMs and accessible information for other patient groups. Routine consideration of the facilitators and barriers identified will contribute to making written information more accessible to people with aphasia.
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Affiliation(s)
- Tanya A Rose
- The University of Queensland, Brisbane, Australia.
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Washington KT, Meadows SE, Elliott SG, Koopman RJ. Information needs of informal caregivers of older adults with chronic health conditions. PATIENT EDUCATION AND COUNSELING 2011; 83:37-44. [PMID: 20452165 DOI: 10.1016/j.pec.2010.04.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Revised: 03/21/2010] [Accepted: 04/07/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To systematically examine current evidence pertaining to information needs of informal caregivers of older adults with chronic health conditions. METHODS Structured search of MEDLINE, MEDLINE IN-PROCESS, CINAHL, and PsycINFO databases to identify studies of caregiver information needs, followed by data extraction and syntheses. RESULTS The 62 articles that met the stated inclusion criteria highlighted extensive needs among informal caregivers for practical, accessible, timely information. CONCLUSION The identified information needs of informal caregivers can inform organizations and agencies that seek to provide disease and illness-related information. PRACTICE IMPLICATIONS Existing evidence supports the implementation of a health information delivery system designed to meet the needs of informal caregivers of older adults with chronic health conditions.
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Affiliation(s)
- Karla T Washington
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, KY 40292, USA.
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Hoffmann T, Cochrane T. What education do stroke patients receive in Australian hospitals? PATIENT EDUCATION AND COUNSELING 2009; 77:187-191. [PMID: 19356883 DOI: 10.1016/j.pec.2009.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 01/06/2009] [Accepted: 03/03/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This study evaluated the educational practices of staff working in acute stroke wards in Australian hospitals, including the coordination and methods of patient education provision, post-discharge education and support services available, and the education and support services that health professionals would like to provide. METHODS Health professionals who worked in acute stroke wards in Australian hospitals were surveyed about the stroke education practices of staff in their ward. Thirty-four hospitals returned a completed questionnaire via email or fax. RESULTS Verbal communication and written materials were the most frequently used methods of information provision. Twenty-three (67.6%) wards developed their own written education materials, five (14.7%) offered group education programs, and 19 (55.9%) offered education or support after discharge. Fourteen (41.2%) wards had a particular staff member responsible for coordinating the provision of education to patients and one (2.9%) ward had a written policy on stroke education. The majority (70.6%) of participants would like to be able to provide more education/support services. CONCLUSION The educational practices of the Australian hospitals surveyed were variable, with improvements needed in the coordination and documentation of patient education and the available follow-up services. PRACTICE IMPLICATIONS Health professionals need to be aware of the importance of education in the care of patients following stroke. Patients' informational needs, while in hospital and after discharge, may be better met if staff in acute stroke wards had improved communication and coordination practices and ensured that stroke education was appropriately documented and supported by policy.
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Affiliation(s)
- Tammy Hoffmann
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Occupational Therapy, Queensland, Australia.
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Ellis-Hill C, Robison J, Wiles R, McPherson K, Hyndman D, Ashburn A, On Behalf Of The Stroke Association. Going home to get on with life: Patients and carers experiences of being discharged from hospital following a stroke. Disabil Rehabil 2009; 31:61-72. [DOI: 10.1080/09638280701775289] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gustafsson L. Information provision during stroke rehabilitation: The health professional's perspective. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2008. [DOI: 10.12968/ijtr.2008.15.3.28728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Louise Gustafsson
- Division of Occupational Therapy, University of Queensland, St Lucia, Brisbane, Queensland, 4072 Australia
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