scholarly journals Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

2021 ◽  
Author(s):  
Katherine McGilton ◽  
Riva Sorin-Peters ◽  
Souraya Sidani ◽  
Veronique Boscart ◽  
Mary Fox ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Staff ◽  
Communication Intervention ◽  
Continuing Care ◽  
Satisfaction With Care ◽  
Control Group ◽  
Post Stroke ◽  
Communication Impairment ◽  
Communication Impairments

Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients’ well-being, quality of life, and satisfaction with care.

scholarly journals Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

2021 ◽  
Author(s):  
Katherine McGilton ◽  
Riva Sorin-Peters ◽  
Souraya Sidani ◽  
Veronique Boscart ◽  
Mary Fox ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Staff ◽  
Communication Intervention ◽  
Continuing Care ◽  
Satisfaction With Care ◽  
Control Group ◽  
Post Stroke ◽  
Communication Impairment ◽  
Communication Impairments

Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients’ well-being, quality of life, and satisfaction with care.

The Nature stroke study; NASTRU - A randomised controlled trial of nature-based post-stroke fatigue rehabilitation

2019 ◽  
Author(s):  
Anna María Pálsdóttir ◽  
Kjerstin Stigmar ◽  
Bo Norrving ◽  
Patrik Grahn ◽  
Ingemar F Petersson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Perceived Value ◽  
Control Group ◽  
Post Stroke ◽  
Randomised Controlled

Abstract Fatigue is common after stroke and contributes to disability and impaired quality of life. Currently, there is insufficient evidence on the efficacy of any intervention for post-stroke fatigue. The aim of the study was to examine whether 10 weeks Nature-based rehabilitation (NRB) as add-on to standard care may improve post-stroke fatigue, perceived value of everyday occupations, function, activity and participation compared to standard care only (Clinical Trial.gov Identifier: NCT02435043, 2012/352, 05-06-2015). The study was carried out as a single blinded two-armed randomised controlled trial. Stroke survivors identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year earlier) were randomised to Standard care + NBR or Standard care only. Blinded evaluations were conducted at follow-up 8 and 14 months after randomisation. The primary outcomes were post-stroke fatigue (Mental Fatigue Scale, total score) and perceived value of everyday occupations (Oval-pd) 8 months after randomisation. About a quarter of the screened patients were eligible; half accepted to participate and 101 were randomised, mean age 67 years, 60% female. The patients with sub-acute stroke were highly compliant with the intervention. Fatigue decreased to a value below the suggested cut-off for mental fatigue (<10.5) in the intervention group but not in the control group; no statistically significant differences were found though between the groups. Conclusion: NASTRU is the first randomised study on NBR for patients with post stroke fatigue. NBR was feasible and well tolerated. The study was underpowered due to difficulties in recruiting participants. No significant differences were detected between intervention and control group. A larger RCT is warranted. Keywords: clinical trial, enriched environment, everyday occupations, horticulture therapy, quality of life.

Stroke rehabilitation and recovery

2021 ◽  
Vol 82 (9) ◽  
pp. 1-7
Author(s):  
Alifa Isaacs-Itua ◽  
Sancho Wong
Keyword(s):  
Quality Of Life ◽  
Stroke Rehabilitation ◽  
Stroke Recovery ◽  
Improve Quality ◽  
Post Stroke ◽  
Communication Impairments

Stroke is the UK's leading cause of disability. Stroke rehabilitation can maximise recovery and improve quality of life. This article discusses some post-stroke impairments, including hemiplegia, dysphagia, communication impairments and neglect, and how rehabilitation can address these. Developing techniques of adaptation or compensation is vital, since the extent of stroke recovery is dependent on successful neuroplasticity, with healthy neurons adapting to compensate for damaged ones.

scholarly journals ‘Do not resuscitate’ decisions in continuing care psychiatric patients: what influences decisions?

2006 ◽  
Vol 30 (10) ◽  
pp. 376-378 ◽  
Author(s):  
Nandini Chakraborty ◽  
William J. Creaney
Keyword(s):  
Quality Of Life ◽  
Nursing Staff ◽  
Psychiatric Patients ◽  
Continuing Care ◽  
Do Not Resuscitate ◽  
Ward Staff ◽  
The Family ◽  
Adult Psychiatry ◽  
Dnr Orders

Aims and MethodWe evaluated the various aspects of ‘do not resuscitate’ (DNR) decisions taken for psychiatric continuing care patients within NHS Ayrshire and Arran. Records were reviewed and nursing staff were asked their opinions about DNR orders in general and the way these were implemented on their wards.ResultsThere were 35 DNR orders among 88 continuing care patients in mental health wards for older adults. There were no DNR orders for the 25 continuing care patients in general adult psychiatry wards. Quality of life was the main issue when taking a DNR decision. Medical and nursing staff were involved in all decisions and the family in most. Patients were involved in only two cases. The documentation of the DNR order itself was satisfactory but documentation of the reasons behind the decision was inadequate. Patients with DNR status were perceived by ward staff to have more physical debilitation and more dependence on others. Local guidelines were being followed in most aspects, but these needed to be reviewed, as suggested within the resuscitation policy itself.Clinical ImplicationsDecisions not to resuscitate may often be difficult to reach in psychiatric patients. Wards follow heterogeneous policies despite a resuscitation policy existing within the trust. Documentation needs to be improved and medical and nursing staff must reach a consensus regarding what constitutes quality of life and the appropriate time for a DNR decision.

scholarly journals Cognitive deficits, social support, depression and quality of life of post-stroke patients

2020 ◽  
Vol 38 (2) ◽  
pp. 153-165
Author(s):  
Flávia Sousa ◽  
Vânia Rocha ◽  
Clara Estima ◽  
São Luís Castro ◽  
Marina Prista Guerra
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Depressive Symptoms ◽  
Cognitive Deficits ◽  
Short Form ◽  
Control Group ◽  
Clinical Group ◽  
Stroke Patients ◽  
Post Stroke

A stroke is a life-threatening event which has physical, emotional and cognitive consequences. Thisstudy aimed to identify differences between participants who suffered a stroke and healthy controls,concerning cognitive performance, depressive symptoms, social support and quality of life; to examinethe associations between these variables among participants who suffered a stroke; and to identify thevariables that best classify patients and controls. The sample included 30 patients who suffered astroke and 30 healthy participants. Both groups presented similar sociodemographic characteristics.All participants were assessed with The Institute of Cognitive Neurology Frontal Screening, theMontreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Instrumental-Expressive Social-Support Scale, and the Short Form Health Survey-36. Post-stroke patients had lowercognitive performance, lower social support, lower quality of life and higher depressive symptomsthan the control group. Social support was positively related to quality of life and negatively relatedto depressive symptoms in the clinical group. Cognitive deficits and depressive symptoms correctlyclassified belonging to the clinical group in 85% of cases, and significantly predicted the stroke. Thisstudy underlines the importance of implementing psychological interventions addressing depressivesymptoms and cognitive rehabilitation for post-stroke patients.

scholarly journals The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial

2020 ◽  
Vol 34 (8) ◽  
pp. 1056-1071
Author(s):  
Line Kildal Bragstad ◽  
Ellen Gabrielsen Hjelle ◽  
Manuela Zucknick ◽  
Unni Sveen ◽  
Bente Thommessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Post Stroke ◽  
Related Quality ◽  
Health Related ◽  
The Mean

Objective: To evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at 12 months post-stroke. Design: Multicenter, prospective, randomized, assessor-blinded, controlled trial with two parallel groups. Setting: Community. Subjects: Three-hundred and twenty-two adults (⩾18 years) with stroke within the last four weeks were randomly allocated into intervention group ( n = 166) or control group ( n = 156). Interventions: The intervention group received a dialogue-based intervention to promote psychosocial well-being, comprising eight individual 1–1½ hour sessions delivered during the first six months post-stroke. Main measures: The primary outcome measure was the General Health Questionnaire-28 (GHQ-28). Secondary outcome measures included the Stroke and Aphasia Quality of Life Scale-39g, the Sense of Coherence scale, and the Yale Brown single-item questionnaire. Results: The mean (SD) age of the participants was 66.8 (12.1) years in the intervention group and 65.7 (13.3) years in the control group. At 12 months post-stroke, the mean (SE) GHQ-28 score was 20.6 (0.84) in the intervention group and 19.9 (0.85) in the control group. There were no between-group differences in psychosocial well-being at 12 months post-stroke (mean difference: −0.74, 95% confidence interval (CI): −3.08, 1.60). The secondary outcomes showed no statistically significant between-group difference in health-related quality of life, sense of coherence, or depression at 12 months. Conclusion: The results of this trial did not demonstrate lower levels of emotional distress and anxiety or higher levels of health-related quality of life in the intervention group (dialogue-based intervention) as compared to the control group (usual care) at 12 months post-stroke.

scholarly journals Effect of Structured Yoga Program on Stress and Professional Quality of Life Among Nursing Staff in a Tertiary Care Hospital of Delhi—A Small Scale Phase-II Trial

2021 ◽  
Vol 26 ◽  
pp. 2515690X2199199
Author(s):  
Suprakash Mandal ◽  
Puneet Misra ◽  
Gautam Sharma ◽  
Rajesh Sagar ◽  
Shashi Kant ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Staff ◽  
Intervention Group ◽  
Control Group ◽  
Wait List ◽  
Professional Quality Of Life ◽  
Wait List Control Group ◽  
Wait List Control ◽  
Professional Quality

Background. Nursing staff suffer from various level of stress and burnout. We aimed to assess the effect of 12 weeks of structured yoga on stress and the professional quality of life among nursing staff. Design and method. An open-label, phase-II randomized clinical trial was undertaken considering a sample size of convenience was done. In service nursing staff were randomized (1:1) to intervention group and wait-list control group. Primary outcome was perceived stress which was measured by Perceived Stress Scale (PSS). Secondary measures were professional quality measured by Professional Quality of Life (ProQOL) scale, blood pressure, serum cortisol, and high-sensitive C-reactive protein. Both the per-protocol and intention to treat analysis was done. Results. Total 113 participants were allocated to intervention group (n = 58, mean = 35 years, SD = 7.9 years) and wait-list control group (n = 55, mean = 32.5 years, SD = 6.8 years). After 12 weeks, 19 participants of intervention group and 32 participants of wait-list control group were included in the per-protocol analysis. Follow-up mean PSS score was 15.4 (95% CI 12.6-18.2, SD 5.8) in intervention group, 20.7 (95% CI 19.7-21.7, SD 2.8) in wait-list control group (p-value < 0.0001). The other parameters didn’t differ between the groups and from baseline to end line too. Conclusions and relevance. The finding showed supervised structured yoga may be efficacious to reduce stress. Studies with larger sample size are needed to confirm the findings. Trial registration. It was approved by the Institute Ethics Committee (Reference no: IECPG-543/20.12.2017, RT-57/31.01.2018) and was registered prospectively in the Clinical Trial Registry of India prospectively (No. CTRI/2018/02/012206).

Results of osteopathic correction of patients with post-traumatic coccygodynia

2019 ◽  
pp. 19-27
Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Emotional State ◽  
Pain Syndrome ◽  
Control Group ◽  
Life Questionnaire ◽  
Treatment Area ◽  
Diffi Cult ◽  
Osteopathic Treatment ◽  
Post Traumatic

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.

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