scholarly journals Socio-demographic and Clinical Correlates of Community Reintegration of Stroke Survivors in Nigeria

2020 ◽  
pp. 1-7
Author(s):  
Muhammad Usman Ali ◽  
Auwal Yahaya Garba ◽  
Adewale Luqman Oyeyemi ◽  
Mamman Ali Masta ◽  
Fatima Kachallah Gujba ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Sampling Technique ◽  
Haemorrhagic Stroke ◽  
Public Hospitals ◽  
Rehabilitation Services ◽  
Stroke Survivors ◽  
Community Reintegration ◽  
Post Discharge ◽  
Post Stroke ◽  
The Impact

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.

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

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Witness Mudzi ◽  
Aimee Stewart ◽  
Eustasius Musenge
Keyword(s):  
Community Participation ◽  
Leisure Activities ◽  
International Classification Of Functioning ◽  
Post Discharge ◽  
Transportation Services ◽  
Post Stroke ◽  
Caregiver Education ◽  
Community Issues ◽  
Formed Part ◽  
The Impact

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.

Abstract TMP103: A Culturally-tailored, Skills-based Intervention to Reduce Vascular Risk in a Multi-ethnic Group of Mild/Moderate Stroke Survivors: An Interim Analysis from the DESERVE Trial

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Bernadette Boden-Albala ◽  
Emily Goldmann ◽  
Aaron S Lord ◽  
Nina S Parikh ◽  
Heather M Kuczynski ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Reduction ◽  
Blood Pressure Reduction ◽  
Stroke Survivors ◽  
Vascular Risk ◽  
Post Discharge ◽  
Vascular Events ◽  
Stroke Incidence ◽  
Culturally Tailored ◽  
The Impact

Introduction: Secondary stroke prevention strategies have proven suboptimal in underserved communities and minority populations. Methods: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) trial tested the efficacy of an innovative skills-based intervention focused on risk perception, medication adherence, and patient-physician communication (vs. usual care enhanced with educational material [EUC]) on blood pressure (BP) reduction among mild/moderate stroke (NIH Stroke Scale ≤ 15) or TIA patients at 1 year post discharge. Study participants were stratified by interview language (English/Spanish) and randomized to intervention or EUC. BP reduction was the difference between systolic BP at baseline and 1-year post-discharge. We assessed differences in baseline characteristics and mean BP reduction between trial arms, overall and by race/ethnicity. Linear regressions evaluated mean difference in blood pressure reduction between trial arms, adjusting for characteristics that differed between trial arms at baseline and language of interview. Results: To date, 290 of 552 stroke/TIA patients recruited at baseline (25% white, 32% black, 36% Hispanic) were evaluated at 1 year (n=145 in each arm). Overall, there was a trend toward greater mean BP reduction in the intervention vs. EUC group (9.3 vs. 6.0 mmHg, p=0.259). Mean BP reduction was significantly greater in the intervention vs. EUC group among Hispanics (9.9 vs. -0.7 mmHg, p=0.040). Among Hispanics, after adjusting for interview language, sex, and place of birth, mean BP reduction was 10.9 mmHg greater in the intervention vs. EUC group (p=0.041). Mean BP reduction did not differ significantly between trial arms among non-Hispanics. We are currently gathering information to evaluate the impact of the intervention on secondary stroke incidence. Conclusions: Few behavioral intervention studies in stroke survivors have reported significant differences in vascular risk reduction in the longer term, and fewer have focused on a skills-based approach. Culturally-tailored, skills-based interventions may be more useful than knowledge-focused interventions in achieving sustained vascular risk reduction and addressing race/ethnic disparities in stroke.

The effect of HIV status on post-stroke outcomes in personal activities of daily living

2020 ◽  
Vol 83 (11) ◽  
pp. 710-718 ◽  
Author(s):  
Hymeri Augustyn ◽  
Patricia de Witt ◽  
Denise Franzsen
Keyword(s):  
Activities Of Daily Living ◽  
Functional Recovery ◽  
Daily Living ◽  
Hiv Positive ◽  
Stroke Survivors ◽  
Post Discharge ◽  
Discharge Data ◽  
Positive Group ◽  
The Impact ◽  
Hiv Negative

Introduction This study explored the impact of HIV on the functional recovery of personal activities of daily living of stroke survivors. This assisted in identifying possible implications for the rehabilitation of stroke survivors who are also HIV-positive. Method A quantitative, descriptive, longitudinal comparative research design was used to determine the change in personal activities of daily living scores of HIV-negative and HIV-positive stroke survivors from admission to 1 month after discharge. Data were collected at a rehabilitation unit using the South African Database Functional Measure. Results There was no difference in the rate and nature of functional recovery of personal activities of daily living between the two groups between admission and discharge. A difference was noticed during the period from admission to 1 month after discharge, during which the HIV-negative group continued to show improvement, while the HIV-positive group showed little improvement or a decline in personal activities of daily living scores. Conclusions While the rate and nature of functional recovery related to personal activities of daily living for HIV-positive and HIV-negative stroke survivors is similar during inpatient care, discharge planning for the HIV-positive group needs to consider the decline in personal activities of daily living functioning post discharge. Regular follow-ups and the inclusion of the stroke survivors in an outpatient treatment programme is recommended.

scholarly journals Racial Disparities in Stroke Recovery Persistence in the Post-Acute Stroke Recovery Phase: Evidence from the Health and Retirement Study

2020 ◽  
Vol 30 (2) ◽  
pp. 339-348
Author(s):  
Joy N. J. Buie ◽  
Yujing Zhao ◽  
Suzanne Burns ◽  
Gayenell Magwood ◽  
Robert Adams ◽  
...  
Keyword(s):  
Racial Differences ◽  
Motor Skills ◽  
Stroke Recovery ◽  
Fine Motor ◽  
Stroke Survivors ◽  
Factors Associated ◽  
Post Stroke ◽  
Stroke Disability ◽  
The Impact

Background and Purpose: Blacks have a higher burden of post-stroke disability. Factors associated with racial differences in long-term post-stroke disability are not well-understood. Our aim was to assess the long-term racial differences in risk factors associated with stroke recovery.Methods: We examined Health and Retire­ment Study (HRS) longitudinal interview data collected from adults living with stroke who were aged >50 years during 2000- 2014. Analysis of 1,002 first-time, non- Hispanic, Black (210) or White (792) stroke survivors with data on activities of daily liv­ing (ADL), fine motor skills (FMS) and gross motor skills (GMS) was conducted. Ordinal regression analysis was used to assess the impact of sex, race, household residents, household income, comorbidities, and the time since having a stroke on functional outcomes.Results: Black stroke survivors were young­er compared with Whites (69 ± 10.4 vs 75 ± 11.9). The majority (~65%) of Black stroke survivors were female compared with about 54% White female stroke survivors (P=.007). Black stroke survivors had more household residents (P<.001) and comor­bidities (P<.001). Aging, being female, being Black and a longer time since stroke were associated with a higher odds of hav­ing increased difficulty in ADL, FMS and/or GMS. Comorbidities were associated with increased difficulty with GMS. Black race increased the impact of comorbidities on ADL and FMS in comparison with Whites.Conclusion: Our data suggest that the effects of aging, sex and unique factors associated with race should be taken into consideration for future studies of post-stroke recovery and therapy.Ethn Dis. 2020;30(2):339-348; doi:10.18865/ ed.30.2.339

Abstract TP141: Navigation Services for Stroke Survivors and Caregivers Post-discharge

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Julia B Richards ◽  
Amy Larson ◽  
Jamie Charbonneau
Keyword(s):  
Caregiver Burden ◽  
Barriers To Care ◽  
Stroke Recovery ◽  
Community Living ◽  
Stroke Survivors ◽  
Post Discharge ◽  
Patient Centered ◽  
Post Stroke ◽  
Medical Issues ◽  
Healthcare It

Background: Patient navigation is a community-based intervention designed to help clients identify and overcome barriers to care. Navigation is a widely used, evidence-based model for patient-centered healthcare. It is well documented that stroke survivors and caregivers face enormous obstacles in returning to their community living situations post-stroke. Purpose: National Stroke Association’s Stroke Recovery Navigator Program is designed to reduce barriers to care, lower incidence of secondary stroke, eliminate re-hospitalization due to post-stroke conditions, and provide support for adjusting to community living. Method: National Stroke Association implemented a pilot program to determine if navigation is an effective intervention for stroke survivors and caregivers. Clients were referred to the program upon discharge from partner hospitals. Clients completed either the Reintegration to Normal Living Index (RTNLI) or the Zarit Screening Measure of Caregiver Burden (respectively) at enrollment and at graduation. Results: The Stroke Recovery Navigator Program received 180 referrals with 90 clients converted to active participation. Stroke survivors made up 82% of participants and caregivers 18%. RTNLI scores went up and Caregiver Burden scores went down when clients received navigation services. During the pilot phase, 12 stroke survivors were re-hospitalized, 4 for stroke-related issues; 8 for new medical issues. Post-pilot evaluations of participants showed that 95% of respondents believe the program provides a valuable service. Referral source surveys revealed that more than half of their patients received information about the program at discharge. Conclusions: Navigation for stroke survivors and caregivers shows increased reintegration to normal living and reduced caregiver burden scores. Clients receiving navigation were re-hospitalized below the levels documented in recent studies. Based on these findings National Stroke Association concludes that navigation post-stroke results in positive outcomes for survivors, caregivers and hospitals.

Abstract 3861: The Effect of Stroke Survivor and Caregiver Family Function and Mutuality on Post Stroke Depression

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kyler M Godwin ◽  
Paul Swank ◽  
Sharon K Ostwald
Keyword(s):  
Structural Model ◽  
Inpatient Rehabilitation ◽  
Stroke Survivor ◽  
Mediating Effect ◽  
Stroke Survivors ◽  
Post Discharge ◽  
Family Function ◽  
Her Family ◽  
Post Stroke ◽  
Post Stroke Depression

Background: Post-stroke depression is common among both stroke survivors and their caregivers. This secondary data analysis explored the effect that stroke survivor and caregiver family function and mutuality, a measure of the perceived positive aspects of the caregiving relationship, had on the depression of spousal dyads over the first 12 months post discharge from inpatient rehabilitation. Methods: Longitudinal meditational analysis was employed to examine the mediating effect of mutuality on the dyads’ perception of family function and caregiver and stroke survivor depression over time. The model was estimated in MPlus version 6.1 using bootstrap estimation with 1000 draws. The final structural model had good model fit to the data with a chi square ( df= 16; N = 132) of 17.55, p =.35, a comparative fit index (CFI) of 0.996, and root mean square error of approximation (RMSEA) of 0.027 (CI = 0-.087). Results: This study included 159 stroke survivors and their spousal caregivers who were an average (standard deviation) age of 66.4 (9.1) and 62.5 (10.5) years, respectively. The majority of stroke survivors were predominately male and non-Hispanic white, although almost 40% of the sample was represented by ethnic minorities. Mutuality was not found to mediate the relationship between caregivers’ and stroke survivors’ perception of family function at baseline and their own or their partners’ depression at 12 months as hypothesized. However, caregivers who perceived healthier family functioning at baseline and stroke survivors who had higher perceived mutuality at 12 months had lower depression at one year post discharge from inpatient rehabilitation (-.117, p=.048; -1.007, p=.034, respectively). Additionally, caregiver mutuality at 6 months, but not at baseline or 12 months, was found to be inversely related to caregiver depression at 12 months (-1.06, p=.04). Conclusions: This study highlights the importance of focusing on the relational aspects of stroke. A stroke does not only happen to the stroke survivor. It affects his or her family, and it oftentimes changes the life of both the stroke survivor and their spousal caregiver. Health professionals should encourage couples who have experienced a stroke to focus on the positive aspects of the caregiving relationship to mitigate post-stroke depression.

scholarly journals Stroke in young adults in Malaysia: 1 year outcome and functional status

2021 ◽  
Vol 26 (4) ◽  
pp. 657-664
Author(s):  
Yean Koon Chan ◽  
Kay Sin Tan ◽  
Lydia Abdul Latif
Keyword(s):  
Small Vessel Disease ◽  
Case Fatality ◽  
Haemorrhagic Stroke ◽  
Education Level ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Large Artery ◽  
Stroke Registry ◽  
Young Stroke ◽  
Post Stroke

Background & Objectives: Young stroke has socioeconomic implications. We aim to describe the demography and evaluate the long-term functional outcomes of young stroke survivors in Malaysia. Methods: First-ever Malaysian young stroke patients (18-50 years) from 1st October 2016 until 30th June 2018 were recruited from the University of Malaya Medical Centre Young Stroke Registry and other sources. Participants were interviewed in person or via telephone at one year post-stroke. Demographic information collected were age, sex, ethnicity, and education level. Results: Out of 120 eligible cases, there were 6 deaths (5%) and 7 recurrent strokes (5.8%) within 1 year. Seventy five patients were recruited for the study with mean assessment time at 14.8 months. Survivors are predominantly male (69.2%), aged ≥41 years old (73%) with racial profile representative of the locality. Ischaemic stroke (IS) is the commonest stroke type (72%) with majority TOAST classified as large-artery atherosclerosis and small-vessel disease. Hypertension and smoking are the leading risk factors. Greater than half are independent and returned to work (RTW); comparatively IS has better outcomes than haemorrhagic stroke (HS). Lesser educated survivors (≤secondary school education, 56%) are more likely to not RTW (OR 5, p = 0.005). There is no significant change in marital status and residence post stroke. Conclusion: In a single centre study in Malaysia, major findings for young stroke survivors, mainly male in their 40s, at 1 year are case fatality of 5%, stroke recurrence of 5.8%, and more than half achieved independence and RTW (IS > HS) with education level influencing RTW.

scholarly journals Changes in stroke rehabilitation during the SARS-CoV-2 shutdown in Switzerland

2021 ◽  
Author(s):  
Jeremia P. O. Held ◽  
Anne Schwarz ◽  
Johannes Pohl ◽  
Eva Thürlimann ◽  
Silvan Porrtmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Community Dwelling ◽  
Outpatient Rehabilitation ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Neurological Functioning ◽  
Observational Cohort ◽  
The Impact

Introduction: Many stroke survivors require continuous outpatient rehabilitation therapy to maintain or improve their neurological functioning, independence, and quality of life. In Switzerland and many other countries, the shutdown to contain SARS-CoV-2 infections led to mobility restrictions and a decrease in therapy delivery. This study investigated the impact of the COVID-19 shutdown on stroke survivors’ access to therapy, physical activity, functioning and mood. Methods: A prospective observational cohort study in stroke subjects. At 4 time-points (before, during, after the shutdown, and at 3-month follow-up), the amount of therapy, physical activities, motor function, anxiety, and depression were assessed. Results: Thirty-six community-dwelling stroke subjects (median 70 years of age, 10 months post-stroke) were enrolled. Therapy reductions related to the shutdown were reported in 72% of subjects. This decrease was associated with significantly extended sedentary time and minimal deterioration in physical activity during the shutdown. Both parameters improved between reopening and 3-month follow-up. Depressive symptoms increased slightly during the observation period. Patients more frequently reported on self-directed training during shutdown. Conclusion: The COVID-19 shutdown had measurable immediate, but no persistent, effects on post-stroke outcomes, except for depression. Importantly, a 2-month reduction in therapy may trigger improvements when therapy is fully re-initiated thereafter.

scholarly journals Correlates of Satisfaction with Community Reintegration Among Stroke Survivors in Kano Metropolis

1970 ◽  
Vol 9 (1-2) ◽  
pp. 34-40
Author(s):  
U.M. Badaru ◽  
A. Nasir ◽  
J. Mohammed ◽  
M.A. Abba ◽  
O.O. Ogwumike ◽  
...  
Keyword(s):  
Social Support ◽  
Rank Order ◽  
Statistical Significance ◽  
Sampling Technique ◽  
Functional Independence ◽  
Significant Loss ◽  
Stroke Survivors ◽  
Community Reintegration ◽  
Cross Sectional Survey ◽  
Cross Sectional

The aim of stroke rehabilitation is to ensure successful reintegration of stroke survivors (SSV) into their communities to enable them effectively discharge their physical, economic and social roles. This study assessed factors related to satisfaction with community reintegration (CR) of SSV in Kano metropolis. It was a cross sectional survey that recruited 68 consenting SSV using the purposive sampling technique. Assessments of CR, physical function, social support and depression were done with Reintegration to Normal Living Index (RNLI), Functional Independence Measure (FIM), Multidimensional Scale of Perceived Social Support (MPSS) and Patient Health Questionnaire (PHQ-9) respectively. Spearman Rank Order Correlation and Wilcoxon Sign Rank tests were used to analyze the data at a level of statistical significance of 0.05 using SPSS version 16.0. A total of 36(52.9%) males and 32(47.1%) females with mean age of 59.69±13.568 years took part in the study. About 50 (73.6%) are modified dependent and 46 (67.6%) enjoyed moderate social support. The majority 87% (N=59) experienced severe restrictions to CR. There were significant correlations between RNLI and each of MSPSS (rho=0.249, p=0.041) and FIM (rho =0.406, p=0.001) scores. Occupational status (Z=-6.693, p=0.000), income (Z=-3.910, p=0.000) and driving status (Z=-5.292, p=0.000) changed significantly. It was concluded that the level of CR of most SSV in Kano metropolis was not satisfactory with significant loss of employment and earnings and ability to drive post stroke. Increased levels of social support and adequate recovery of physical functions are likely to improve satisfaction with CR.KEY WORDS: stroke, satisfaction, community reintegration, social support, driving, return to work

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