scholarly journals Community participation of patients 12 months post-stroke in Johannesburg, South Africa

Author(s):  
Witness Mudzi ◽  
Aimee Stewart ◽  
Eustasius Musenge

Background: Improvement in health-related quality of life (HRQL) is the main goal of rehabilitation. The ability of the stroke-patient to participate in various situations signifies successful rehabilitation. The aim of the study was to establish the extent of community participation and the barriers and facilitators to the participation for stroke patients after their discharge.Method: This study formed part of a larger study focusing on the impact of caregiver education on stroke survivors and their careers. This was a longitudinal study comprising 200 patients with first-time ischaemic stroke. Although the patients were followed up at home at 3 months, 6 months and 12 months post-stroke, this paper focuses on the 12-months follow-up participation results. Patient functional ability was measured by using the Barthel Index (BI) and the Rivermead Mobility Index (RMI), whereas participation was measured by using the International Classification of Functioning, Disability and Health (ICF) checklist. Descriptive statistics were used to analyse the data.Results: Patients experienced severe to complete difficulty when undertaking single and multiple tasks without help 12-months post-discharge. They struggled with the preparation of meals, household work and interpersonal interactions, and they had difficulties with community life and partaking in recreation and leisure activities. Immediate family and societal attitudes were viewed as facilitators to community participation whereas friends, transportation services and social security services were viewed as barriers to community participation.Conclusion: The patient-ability to socialise and participate in community issues is currently poor. The identified barriers to community participation need to be addressed in order to improve patient-participation in the community post-stroke.

2020 ◽  
Vol 51 (1) ◽  
pp. 31-41
Author(s):  
Xiangli Chen ◽  
Veronica Muller ◽  
Beatrice Lee ◽  
Jia-Rung Wu ◽  
Kanako Iwanaga ◽  
...  

BackgroundFibromyalgia (FM) is a lifelong central nervous system disorder that can have a significant impact on an individual's functionality, community participation, employment, health-related quality of life, and life satisfaction. In the present study, we adopted the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) model as a research framework to examine the impact of FM on community participation and life satisfaction.PurposeThe present study investigates the moderating and mediating effects of community participation on the relationship between functional disability and life satisfaction.ResultsThe results indicated community participation is both a significant mediator and moderator for the relationship between functional disability and life satisfaction.ImplicationsThe negative relationship between functional disability and life satisfaction diminished when individuals with FM had high levels of community participation, and functional disability had indirect effects on life satisfaction through community participation. It is important to continue this particular line of research in order to identify specific interventions that can help individuals increase community participation and life satisfaction.


2020 ◽  
pp. 213-230
Author(s):  
Dee Webster ◽  
Sally Knapp

‘Communication disorders after stroke’ examines the common communication disorders which occur post-stroke and their impact on all aspects of daily life for the older person. It describes impairments of language and speech: aphasia, dysarthria, and apraxia of speech, outlining the theoretical models underpinning assessment and treatment, with specific reference to auditory comprehension, reading, the production of spoken language and spelling. The International Classification of Functioning framework which guides the assessment and rehabilitation of communication disorders, and the methods used to assess breakdown of communication are detailed. The role of the speech and language therapist is explored. The impact of spontaneous recovery and the internal and external factors which impact on suitability for therapy are described. The role of collaborative goal setting is outlined and intervention approaches targeted at the level of the impairment and at increasing communicative activity and social and life participation are explored. The impact of digital literacy, health-related quality of life, and the challenges of the care home setting on the older population are also examined.


Author(s):  
Muhammad Usman Ali ◽  
Auwal Yahaya Garba ◽  
Adewale Luqman Oyeyemi ◽  
Mamman Ali Masta ◽  
Fatima Kachallah Gujba ◽  
...  

Background: Low level of community reintegration among stroke survivors is a major obstacle to rehabilitation services post discharge from acute care. Few studies have assessed the impact of community reintegration on stroke survivors in Nigeria. This study investigates community reintegration and associated factors among stroke survivors in Maiduguri, Nigeria. Methodology: Purposive sampling technique was used to recruit 55 stroke survivors attending rehabilitation services from two public hospitals in Maiduguri. Community reintegration was assessed with the Reintegration to Normal Living Index (RNLI) questionnaire, while information on sociodemographics (e.g., age group, gender, employment status, educational status) and clinical characteristics (e.g., post stroke duration, types of stroke, side of affectation) was obtained using the data form. Logistic regression analyses with odd ratios were used to test the associations between community reintegration and sociodemographic and clinical characteristics. Results: The mean age and post stroke duration of the participants were 44.69±13.06 years and 17.25±24.90 months respectively. The participants’ community reintegration scores showed that 60%, 38.2% and 1.8% have no integration, mild to moderate reintegration and complete reintegration respectively. The results indicated that stroke survivors with a stroke duration greater than 8 months (OR=3.32, C.I=1.08-10.27) and those with haemorrhagic stroke (OR=4.67, C.I=1.05-20.66) were more likely to be reintegrated into the community than their counterparts with 6-8 months post stroke duration and ischaemic stroke, respectively. There was significant association between community reintegration and sociodemographic characteristics such as post stroke duration and type of stroke. Conclusions: Rehabilitation strategies should focus on clinical characteristics of the stroke survivors when planning and delivering effective community reintegration interventions.


Mousaion ◽  
2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Harry Ramothupi Matolong

Statistics and numerous authors have highlighted the reading crisis in South Africa. At the same instance, more people in South Africa are embracing the potential of digital technology to provide lifelong learning opportunities and also to strengthen the culture of reading. This study is framed against the backdrop and implementation of the Mzansi Libraries On-Line Project in South Africa – a project implemented in line with the Global Libraries Programme of the Bill & Melinda Gates Foundation. The study explored the potential of access to information of digital technology and the contribution of the project to inculcating a culture of reading at public libraries. A benchmark survey was conducted by an independent research company during the pilot phase of the project in 2015. This survey covered library users of the 27 libraries that formed part of the pilot phase, and a further 25 libraries from a representative sample across South Africa. An end-line survey was conducted through a private company towards the conclusion of the countrywide implementation in 2017, based on the Common Impact Measurement System which was customised for South Africa. The benchmark survey found that although ICT in libraries had been used by relatively few people in 2015, the impact of this technology tended to be positive and would be beneficial to the wider society by helping to redress societal imbalances, including education and the culture of reading. The end-line survey found increased benefits of library usage and library technical infrastructure to improve the lives of the communities involved.


2021 ◽  
pp. ijgc-2020-002192
Author(s):  
Serena Cappuccio ◽  
Yanli Li ◽  
Chao Song ◽  
Emeline Liu ◽  
Gretchen Glaser ◽  
...  

ObjectiveTo evaluate trends in outpatient versus inpatient hysterectomy for endometrial cancer and assess enabling factors, cost and safety.MethodsIn this retrospective cohort study, patients aged 18 years or older who underwent hysterectomy for endometrial cancer between January 2008 and September 2015 were identified in the Premier Healthcare Database. The surgical approach for hysterectomy was classified as open/abdominal, vaginal, laparoscopic or robotic assisted. We described trends in surgical setting, perioperative costs and safety. The impact of patient, provider and hospital characteristics on outpatient migration was assessed using multivariate logistic regression.ResultsWe identified 41 246 patients who met inclusion criteria. During the time period studied, we observed a 41.3% shift from inpatient to outpatient hysterectomy (p<0.0001), an increase in robotic hysterectomy, and a decrease in abdominal hysterectomy. The robotic hysterectomy approach, more recent procedure (year), and mid-sized hospital were factors that enabled outpatient hysterectomies; while abdominal hysterectomy, older age, Medicare insurance, black ethnicity, higher number of comorbidities, and concomitant procedures were associated with an inpatient setting. The shift towards outpatient hysterectomy led to a $2500 savings per case during the study period, in parallel to the increased robotic hysterectomy rates (p<0.001). The post-discharge 30-day readmission and complications rate after outpatient hysterectomy remained stable at around 2%.ConclusionsA significant shift from inpatient to outpatient setting was observed for hysterectomies performed for endometrial cancer over time. Minimally invasive surgery, particularly the robotic approach, facilitated this migration, preserving clinical outcomes and leading to reduction in costs.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lamis R. Karaoui ◽  
Elsy Ramia ◽  
Hanine Mansour ◽  
Nisrine Haddad ◽  
Nibal Chamoun

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pietro Coletti ◽  
Pieter Libin ◽  
Oana Petrof ◽  
Lander Willem ◽  
Steven Abrams ◽  
...  

Abstract Background In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. Methods We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Results Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Conclusions Contacts during leisure activities are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment of social contacts in the population is therefore crucial to adjust to evolving behavioral changes that can affect epidemic diffusion.


Author(s):  
Małgorzata Paprocka-Borowicz ◽  
Mona Wiatr ◽  
Maria Ciałowicz ◽  
Wojciech Borowicz ◽  
Agnieszka Kaczmarek ◽  
...  

Stroke is a high-risk factor for depression. Neurological rehabilitation is greatly difficult and often does not include treatment of depression. The post-stroke depression plays an important role in the progress of treatment, health, and the life of the patient. The appropriate treatment of depression could improve the quality of life of the patient and their family. The study aimed to evaluate the impact of physical activity and socio-economic status of the patient on the effectiveness of recovery from depression and the severity of the symptoms of depression. The study was conducted with 40 patients after stroke aged 42–82 years, and included 10 women and 30 men who were hospitalized for two weeks. The severity of depression/anxiety (D/A) symptoms were evaluated two times; at admission and after two weeks of physical therapy. The hospital anxiety and depression scale (HADS) questionnaire was used for this purpose. Socio-economic status was evaluated by several simple questions. It was revealed that physical therapy has a positive influence on mental state. The severity of D/A symptoms after stroke is related to the financial status of the patients (2 = 11.198, p = 0.024). The state of health (2 = 20.57, p = 0.022) and physical fitness (2 = 12.95, p = 0.044) changed the severity of symptoms of anxiety and depressive disorders. The kinesiotherapy in the group of patients with post-stroke depression had positive effects; however, economic and health conditions may influence the prognosis of the disease.


2021 ◽  
pp. 1-23
Author(s):  
Merih Ates ◽  
Valeria Bordone ◽  
Bruno Arpino

Abstract This study investigates the impact of non-intensive and intensive supplementary grandparental child care on grandparents’ involvement in leisure activities. Three aspects of leisure activities are investigated: the number/frequency of activities, with whom they are carried out and the subjective satisfaction with them. Beside the possibility of a cumulation effect, the literature suggests that providing grandparental child care might compete with other activities, especially for women. Thus, we consider role enhancement and role strain theories to derive our hypotheses. We use longitudinal data from the German Ageing Survey (DEAS) which contains rich information on the leisure activities of people aged 40 and older. To account for selection into the provision of grandparental child care, we use a within-unit estimation approach (fixed-effects panel models). Our results show that both grandfathers and grandmothers tend to engage in more leisure activities when they provide grandparental child care. While care-giving grandfathers become more likely to engage in activities with family members without changing their engagement outside the family, we found no effect for women in this respect. Nevertheless, grandparental child-care provision modifies satisfaction with leisure activities only for women, reducing it, independently from with whom leisure activities are carried out. These findings suggest that a higher quantity of leisure activities does not necessarily imply higher quality.


2021 ◽  
pp. 174462952110221
Author(s):  
Darren McCausland ◽  
Esther Murphy ◽  
Mary McCarron ◽  
Philip McCallion

Person-centred planning (PCP) puts individuals with an intellectual disability at the centre of service and support planning, identifying how individuals wish to live their lives and what is needed to make that possible. PCP has been identified as having the potential to facilitate improved social inclusion and community participation. A mixed-methods approach combined quantitative analyses with qualitative case studies of individuals with severe-profound intellectual disability to assess the impact of PCP on community participation for adults with an intellectual disability at a disability service in Dublin. We conclude that PCP may provide a good basis to plan community participation and, with the right supports in place, may provide opportunities for people with complex needs to improve their community participation. Supports including familiar staff and family are critical to the success of PCP for people with complex needs, and their absence may undermine the best intentions of PCP for this population.


Sign in / Sign up

Export Citation Format

Share Document