Evidence-Based Optimization of the Mandarin Version of the Post Stroke Checklist: A Mixed Methods Study

Abstract Background: The Post Stroke Checklist has been proved to be feasible and useful in standardizing the process for long-term post-stroke care and we developed a Mandarin version of it (M-PSC). However, it is not capable of enforcing follow-up care after stroke and further optimization is needed.Methods: Participants were consecutively recruited from 13 departments in a specialized hospital on the discharge date. The trained clinicians contacted them by telephone calls at six months since the most recent diagnosis. A satisfaction questionnaire was sent to the participant whilst clinicians completed a satisfaction questionnaire and the Pragmatic Face and Content Validity Test (PRAC-Test). Then, a debriefing meeting was held to discuss potential problems of the M-PSC. Quantitative and qualitative data were both collected from April 2021 to May 2021.Results: A total of 167 individuals consented to take part in the study.113 participants completed the assessment at six months and three were excluded due to missing data. The M-PSC identified a wide range of unmet needs related to stroke and at least one need was reported in 76.4% of participants. The average time taken to administer the M-PSC was 8 mins. Satisfaction ratings were high for participants (8.5/10) and clinicians (9.6/10). Totally 31 further screenings were conducted and 33 appropriate referrals were accomplished. Several areas for improvement were identified and revised.Conclusions: The M-PSC is a feasible and useful measure in enforcing follow-up care and promising to be an approach in standardizing post-stroke follow-up practice in telehealth during the coronavirus disease 2019 pandemic.

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Do work ability and life satisfaction matter for return to work? Predictive ability of the work ability index and life satisfaction questionnaire among women with long-term musculoskeletal pain

BMC Public Health ◽

10.1186/s12889-021-10510-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mamunur Rashid ◽

Marina Heiden ◽

Annika Nilsson ◽

Marja-Leena Kristofferzon

Keyword(s):

Life Satisfaction ◽

Back Pain ◽

Sick Leave ◽

Work Ability ◽

Work Ability Index ◽

Discriminative Ability ◽

Satisfaction Questionnaire ◽

Ability Index

Abstract Background Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW.

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Self-reported late effects and long-term follow-up care among 1889 long-term Norwegian Childhood, Adolescent, and Young Adult Cancer Survivors (the NOR-CAYACS study)

Supportive Care in Cancer ◽

10.1007/s00520-020-05790-6 ◽

2020 ◽

Author(s):

A. V. Mellblom ◽

C. E. Kiserud ◽

C. S. Rueegg ◽

E. Ruud ◽

J. H. Loge ◽

...

Keyword(s):

Young Adult ◽

Late Effects ◽

Adolescent And Young Adult ◽

Young Adult Cancer Survivors ◽

Adult Cancer Survivors ◽

Follow Up Care ◽

Long Term Follow Up ◽

Young Adult Cancer

Abstract Purpose The majority of childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of late effects but may not receive long-term follow-up care for these. Here, we investigated (1) self-reported late effects, (2) long-term follow-up care, and (3) factors associated with receiving follow-up care in a population-based sample of Norwegian long-term CAYACS. Methods Survivors were identified by the Cancer Registry of Norway. All > 5-year survivors diagnosed between 1985 and 2009 with childhood cancer (CCS, 0–18 years old, excluding CNS), breast cancer (BC, stages I–III), colorectal cancer (CRC), leukemias (LEUK), non-Hodgkin lymphoma (NHL), or malignant melanoma (MM) at age 19–39 years were mailed a questionnaire (NOR-CAYACS study). Descriptive statistics and logistic regression models were used to analyze occurrence of late effects, long-term follow-up care for these, and associated factors. Results Of 2104 responding survivors, 1889 were eligible for analyses. Of these, 68% were females, with a mean age of 43 years at survey, on average 17 years since diagnosis, and diagnosed with CCS (31%), BC (26%), CRC (8%), NHL (12%), LEUK (7%), and MM (16%). Overall, 61.5% reported the experience of at least one late effect, the most common being concentration/memory problems (28.1%) and fatigue (25.2%). Sixty-nine percent reported not having received long-term follow-up care focusing on late effects. Lower age at survey (p = 0.001), higher education (p = 0.012), and increasing number of late effects (p = < 0.001) were associated with increased likelihood of follow-up care in the multivariate model. Conclusions The majority of survivors reported at least one late effect, but not receiving specific follow-up care for these. This indicates a need for structured models of long-term follow-up to ensure adequate access to care.

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Evolution of survivorship in lymphoma, myeloma and leukemia: Metamorphosis of the field into long term follow-up care

Blood Reviews ◽

10.1016/j.blre.2018.07.003 ◽

2019 ◽

Vol 33 ◽

pp. 63-73 ◽

Cited By ~ 14

Author(s):

Moussab Damlaj ◽

Riad El Fakih ◽

Shahrukh K. Hashmi

Keyword(s):

Follow Up Care ◽

Long Term Follow Up

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Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

Journal of Clinical Oncology ◽

10.1200/jco.2011.38.6938 ◽

2012 ◽

Vol 30 (27) ◽

pp. 3408-3416 ◽

Cited By ~ 104

Author(s):

Lisa B. Kenney ◽

Laurie E. Cohen ◽

Margarett Shnorhavorian ◽

Monika L. Metzger ◽

Barbara Lockart ◽

...

Keyword(s):

Young Adult ◽

Reproductive Health ◽

Task Force ◽

Young Male ◽

Adolescent And Young Adult ◽

Male Survivors ◽

Male Health ◽

Follow Up Care

The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors.

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TIA and minor stroke: A qualitative study of long-term impact and experiences of follow-up care

10.21203/rs.2.13276/v2 ◽

2019 ◽

Author(s):

Grace M Turner ◽

Christel McMullan ◽

Lou Atkins ◽

Robbie Foy ◽

Jonathan Mant ◽

...

Keyword(s):

Qualitative Study ◽

Stroke Prevention ◽

Community Care ◽

Minor Stroke ◽

Framework Analysis ◽

Diverse Range ◽

Follow Up Care ◽

The Impact

Abstract Background Transient ischaemic attack (TIA) and minor stroke are often considered transient events; however, many patients experience residual problems and reduced quality of life. Current follow-up healthcare focuses on stroke prevention and care for other long-term problems is not routinely provided. We aimed to explore patient and healthcare provider (HCP) experiences of residual problems post-TIA/minor stroke, the impact of TIA/minor stroke on patients’ lives, and current follow-up care and sources of support. Methods This qualitative study recruited participants from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Semi-structured interviews were conducted with 12 TIA/minor stroke patients and 24 HCPs from primary, secondary and community care with framework analysis. Results A diverse range of residual problems were reported post-TIA/minor stroke, including psychological, cognitive and physical impairments. Consultants and general practitioners generally lacked awareness of these long-term problems; however, there was better recognition among nurses and allied HCPs. Residual problems significantly affected patients’ lives, including return to work, social activities, and relationships with family and friends. Follow-up care was variable and medically focused. While HCPs prioritised medical investigations and stroke prevention medication, patients emphasised the importance of understanding their diagnosis, individualised support regarding stroke risk, and addressing residual problems. Conclusion HCPs could better communicate lay information about TIA/minor stroke diagnosis and secondary stroke prevention, and improve their identification of and response to important residual impairments affecting patients.

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Serving Students With Acquired Brain Injury: Understanding Long-Term Need and Outcomes After the BrainSTEPS Program

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2021_persp-21-00059 ◽

2021 ◽

pp. 1-14

Author(s):

Jessica Salley Riccardi ◽

Libby Crook ◽

Brenda Eagan-Johnson ◽

Monica Vaccaro ◽

Angela H. Ciccia

Keyword(s):

Brain Injury ◽

Regular Education ◽

Acquired Brain Injury ◽

Transition Services ◽

Student Outcome ◽

Severe Injuries ◽

School Based ◽

Wide Range

Purpose: The purpose of this study was to inform school-based services for children with acquired brain injury (ABI) by describing and analyzing functional student-outcome data from a state-wide, school-based, school re-entry consultation program, BrainSTEPS (Strategies Teaching Educators, Parents, and Students), in Pennsylvania. Method: A nonexperimental, retrospective analysis was conducted with data collected during a pilot follow-up survey for BrainSTEPS. Caregivers reported on 337 students with ABI participating in BrainSTEPS. Results: Most students post-ABI who were participating in BrainSTEPS were enrolled in regular education and reported no ongoing symptoms, as well as no parent perception of need for additional BrainSTEPS consultation during the time period of the follow-up survey. Current receipt of therapy was significantly associated with injury type, χ 2 (1, n = 329) = 16.72, p < .001. A multiple logistic regression was significant ( p < .001) in predicting the need for additional BrainSTEPS consultation. More severe injuries, educational placement postinjury of regular education with a 504 plan (compared to regular education), and current receipt of therapy significantly increased the odds of need for consultation. Conclusions: Due to the wide range of experiences of students in this sample, hospital-to-school transition services, educational supports and services, and long-term follow-up must be individualized for children with ABI. Speech-language pathologists are critical members of the school-based academic team for students with ABI to decrease long-term unmet needs.

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Abstract WP202: Decompressive Hemicraniectomy After Malignant Middle Cerebral Artery Ischemic Stroke in a Developing Country is Associated With Poor Long Term Functional Outcome and High Mortality

Stroke ◽

10.1161/str.51.suppl_1.wp202 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Hellen C Homem ◽

Francisco J Montalverne ◽

Fernanda M Carvalho ◽

Francisco Ramos Junior ◽

Heitor F Ramos ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Middle Cerebral Artery ◽

Functional Outcome ◽

Stroke Care ◽

Rehabilitation Services ◽

Decompressive Hemicraniectomy ◽

Malignant Mca Infarction

Background: Decompressive hemicraniectomy (DH) is a level IA therapy for malignant middle cerebral artery (MCA) infarction. However, randomized trials were performed in high income countries with better access to post-stroke care and rehabilitation services. We aimed to assess long term functional outcome and the associated prognostic factors of patients undergoing DH in Brazil. Methods: From January 2013 and July 2018, all patients undergoing DH for malignant MCA infarction in a single comprehensive stroke center were retrospectively identified. Outcomes were the modified Rankin Scale (mRS) (dichotomized as ≤ 4 vs. > 4) and mortality at follow-up. The mRS at follow-up was collected prospectively by telephone using a validated structured interview. Logistic regression analysis was performed to assess independent predictors of outcome. Results: Eighty patients who underwent DH for malignant MCA infarction were identified. Age ranged from 16 to 78 years (median 48 years, IQR 42 - 54,7 years), 46 (57.6%) were males and median time from stroke onset to hemicraniectomy was 30.75 hours (IQR 17.8-46.0). Hospital discharge mRS ≤ 3 and ≤ 4 was observed in 5 (6.2%) and 74 (92,5%) patients respectively. Follow-up information was available for 65 (81.2%) patients. At follow-up (raging from 1.1 to 5.6 years), mRS ≤ 4 was observed in 23 (35.3%) patients. In binary logistic regression analysis, age (OR 1.09, 95% CI 1.02 - 1.17, p=0.01), and right MCA infarction (OR 16.70, 95% CI 1.8-152.30, p=0.01) were independently associated with a worse functional outcome at follow-up. Admission NIHSS (OR 1.0 ,95% CI 0.8-1.3, p=0.45), IV rt-PA (OR 0.5, 95% CI 0.08-3.00, p=0.46) or time of hemicraniectomy (OR 1.00, 95% CI 1.00 - 1.00, p=0.94) were not associated with functional outcome at follow-up. Mortality was 26% (N=21) at hospital discharge and 46% (N=30) at follow-up. Conclusion: The large effect size of DH for malignant MCA infarction is significantly diminished in the population of patients treated under the less than ideal conditions typically found in the public healthcare system of a developing country. Poor access to post-stroke care and rehabilitation services might be possible reasons for the results observed.

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