Self-Care Needs of Caregivers Dealing with Stroke

2006 ◽  
Vol 38 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Amanda M. Cook ◽  
Linda L. Pierce ◽  
Barbara Hicks ◽  
Victoria Steiner
Keyword(s):  
10.2196/17855 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e17855 ◽  
Author(s):  
Tina Gustavell ◽  
Kay Sundberg ◽  
Ann Langius-Eklöf

Background Pancreatic and periampullary cancers are rare but have high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates a health care system responsive to these needs and health care professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support for self-care. The app has been shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer. Objective The aim of the study was to describe how patients used the Interaktor app following pancreaticoduodenectomy due to cancer and their experience with doing so. Methods A total of 115 patients were invited to use Interaktor for 6 months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped out, and 46 did not meet the inclusion criteria after surgery, leaving 26 patients for inclusion in the analysis. The patients were instructed to report symptoms daily through the app for up to 6 months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts, and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences, and the data were analyzed using thematic analysis. Results The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported symptoms. Alerting symptoms were reported by 24 patients, and the most common alert was fever. There were variations in how many times the patients viewed the self-care advice (range 3-181 times). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews, the overarching theme was “Being seen as a person,” with the following 3 sub-themes: “Getting your voice heard,” “Having access to an extended arm of health care,” and “Learning about own health.” Conclusions Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in their own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than patients receiving only standard care.


Author(s):  
Olivia Carroll ◽  
Kristin Nxumalo ◽  
Amber Bennett ◽  
Whitney Pike

Objective: To demonstrate the effectiveness of an outpatient occupational therapy program on improving self-care for individuals with heart failure. Background: Hospitalizations for heart failure (HF) are the largest Medicare expenditure, and 12% of these admissions are considered preventable. Effective self-management of the debilitating symptoms associated with HF (shortness of breath, fatigue, fluid retention, cognitive decline) helps keep patients out of the hospital. Individuals often experience difficulty incorporating self-care management activities into their daily lives. Occupational therapy (OT) is well suited to address the self-care needs of people with HF by increasing patient self-efficacy and facilitating lifestyle modification through the incorporation of new habits, roles, and routines. Methods: Participants with HF (n=11, ages 40-86) enrolled in an outpatient OT program focusing on self-care management. Participants received weekly, bi-weekly or monthly one-hour treatments over a six-month period. Sessions addressed the following topics: low sodium diet adherence, medication management, activity tolerance, symptom monitoring and psychosocial coping strategies. The Self-Care of Heart Failure Index (SCHFI) was administered at evaluation and upon completion of the program. The SCHFI is a reliable and valid assessment tool that measures self-care maintenance, management and confidence in people with HF. Results: All participants who received two or more treatments demonstrated 33.33% (16.67 of 49.99) to 190.01% (63.33 of 33.33) improvement in maintenance of self-care routines based on pre and post SCHFI scores. Additionally, half of these participants demonstrated 28.47% (22.16 of 77.84) to 85.33% (38.4 of 45) improvement in confidence with self-care management based on pre and post SCHFI scores. Conclusion: Participation in an outpatient OT program that focused on incorporating lifestyle modifications into daily routines was effective at improving self-care for people with HF, specifically maintenance of self-care routines and confidence with ability to self-manage their chronic condition.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Amber Bennett ◽  
Kristin Nxumalo ◽  
Whitney Pike ◽  
Olivia Carroll

Introduction: Hospitalizations for heart failure (HF) are the highest single Medicare expenditure. This cost primarily results from readmissions linked to failed self-care. Evidence suggests that effective self-care routines are equivalent to medication in preventing HF exacerbation and hospitalization. Occupational therapists (OT) are well suited to address HF self-care needs by facilitating self-efficacy and adapting patients’ routines, roles and habits. A recent study determined that OT is the only hospital spending category associated with lower HF readmission rates. Hypothesis: Occupational therapy has a significant role in addressing the self-care management needs of patients with HF throughout the continuum of care. Methods: The OT department launched a HF self-care management program as part of process improvement initiatives at an AHA-recognized teaching hospital. An assessment battery was developed which included the following: The Self-Care of Heart Failure Index (SCHFI) v.6.2, Minnesota Living With Heart Failure Questionnaire, Patient Health Questionnaire-9, and the Montreal Cognitive Assessment. Administration of the OT HF assessment battery to a pilot group of 12 inpatients revealed factors that affect patient adoption and adherence to beneficial self-care management routines. Based on assessment battery data, an outpatient OT program was established. Eleven outpatients were enrolled and completed 3-6 hours of OT treatment. The SCHFI was administered at program evaluation and completion to measure self-care maintenance and confidence. To expand service access, a telehealth self-care program was introduced and a single patient case study was assessed to determine the feasibility and effectiveness of the virtual format. Results: Assessment battery data enabled the development of outpatient treatment modules focusing on symptom monitoring, medication management, low sodium diet, activity tolerance and psychosocial strategies. All outpatients who completed the modules demonstrated improved self-care maintenance (ranging from 16-53 points) and half demonstrated improved self-care confidence (ranging from 6-39 points). The patient assessed after completing the telehealth program demonstrated improved self-care maintenance (70 points) and self-care confidence (28 points). Conclusions: In conclusion, OT has a significant role in addressing the self-care management needs of patients with HF throughout the continuum of care. The utilization of a standardized OT HF assessment battery is effective in determining the needs of this population and for guiding the implementation of targeted individualized treatment. Outpatient and telehealth delivery of OT programming is effective in improving self-care for people with HF.


2020 ◽  
Vol 83 (8) ◽  
pp. 530-537
Author(s):  
Lorna Wales ◽  
Carolyn Dunford ◽  
Kathy Davis

Introduction Stroke is a major cause of mortality and disability in childhood. There is a false belief that children will recover better than adults and recent research confirms that younger age at injury can have a negative impact on rehabilitation outcomes, resulting in lifelong disability. Self-care is a key rehabilitation outcome for children and young people. Methods This service evaluation reviews routinely collected clinical self-care data from one specialised residential rehabilitation centre in the United Kingdom. Admission and discharge scores from the United Kingdom Functional Independence Measure +Functional Assessment Measure, Rehabilitation Complexity Scale – E and Northwick Park Nursing Dependency Scale were analysed. Results Twenty-six children and young people age 8 years and over with severe stroke were included. Mean scores of independence increased and mean scores of complexity and dependency decreased. A proportion of the sample had ongoing self-care needs in relation to support needed in washing, dressing and bathing. A small number remained highly dependent, requiring assistance from two carers. Conclusion Children and young people make significant gains in self-care independence during specialised rehabilitation. However, a proportion return to the community with high self-care needs. Occupational therapists and the wider care team should address ongoing self-care needs in this population.


Author(s):  
Massy Mutumba ◽  
Henry Mugerwa ◽  
Victor Musiime ◽  
Anudeeta Gautam ◽  
Hellen Nakyambadde ◽  
...  

The heightened vulnerability of adolescents to poor HIV care outcomes underscores the need for interventions that create and promote HIV self-management behavioral skills. Adolescents living with HIV (ALHIV) experience a complex array of physical, emotional, and social challenges that constrain their self-care, but the majority of existing psychosocial programs focus primarily on medication adherence. Understanding adolescents’ self-care needs, challenges, and preferences is necessary for developing effective culturally relevant interventions. The involvement of caregivers and stakeholders is also critical to realizing positive self-care outcomes. This article presents the findings from focus group discussions with ALHIV, caregivers, and healthcare providers on self-care. The data were collected as part of formative research in the development of a self-management intervention for Ugandan ALHIV. Participants’ discussions on self-care strategies and intervention approaches provide valuable insights to guide the development of interventions to promote positive HIV care outcomes among Ugandan ALHIV.


2015 ◽  
Vol 4 (2) ◽  
pp. 88
Author(s):  
Fery Agusman Motuho Mendrofa ◽  
Chatarina U. Wahyuni ◽  
Nursalam Nursalam ◽  
Hasan Machfoed ◽  
Kuntoro Kuntoro ◽  
...  

Stroke injury such as physical and psychological disorders was required assistance such as the community, nursing professional and family. Family and social factors play an important role in independence strokes such as support family members provide encouragement for self care.The objective of aim the study wasto assess indicator of self care and model family support related self care. A cross-sectional survey research design was used. Data was collected with interviews by home visited method. Data were analyzed with confirmatory analysis for determined of validity and reliability indicator, models analyzed by SEM (<em>Structural Equation Model</em>).Family support such as information, instrumental, reward and emotion were valid indicator for family support. Self care indicators such as eat, bath, titivate, dress, defecating, urination and transfer to building of self-care. Indicators of eating, bathing, titivate, dress, defecate, urination, and transfer is an indicator for self care. It could be concluded that eating, bathing, ornate, dress, and the transfer is valid and reliable. Model showed that self-care needs were improved of self-carepatients with through family support.


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