A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: one year follow-up of caregivers

Bertilsson, Ann Sofie; Eriksson, Gunilla; Ekstam, Lisa; Tham, Kerstin; Andersson, Magnus; Koch, Lena von; Johansson, Ulla

doi:10.1177/0269215515603780

Cited by 21 publications

(36 citation statements)

References 37 publications

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“…Family members play a vital role in stroke recovery and rehabilitation, enabling many of those with stroke to have an acceptable quality of life and remain living in the community (57). Due to stroke, family members could suffer from depression and anxiety, family tensions and financial problems (58,59). It is imperative that the family members access useful information and advice about the care and rehabilitation of a person with stroke and receive skills training, emotional support and regular relief.…”

Section: Family-centerednessmentioning

confidence: 99%

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Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

Kamwesiga

Tham

Guidetti

2016

Disability and Rehabilitation

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Aim The aim of this study was to describe the experiences and meaning of using mobile phones in everyday life after stroke, among persons with stroke and their family members. Methods Qualitative semi-structured interviews were conducted among 11 persons with stroke and 9 family members 2 months to 2 years after the stroke. The interviews were analysed by using constant comparative grounded theory (GT) approach. Results Seven categories were identified from the analysis of the participants' experiences. The mobile phone: (1) as an enabler of communication and connections with other people, (2) a source of inspiration for agency, (3) structuring routine and activities in daily life, (4) as a facilitator of social and economic wellbeing of an individual or family, (5) promoter of belonging and participation in social relationships, (6) facilitator of reintegration to community living and (7) enabler of family members to feel secure. From these categories, a core category emerged: The mobile phone as a "life line" and an extension of the body enabling connection, belonging and agency to act in a complex everyday life situation. Conclusion The study gives support for the possibility of using mobile phones to facilitate change and community integration in the rehabilitation process after stroke. Implications for Rehabilitation Stroke leads to decreased functioning in everyday life due to impairments, activity limitations and participation restrictions as well caregiver burden. Mobile phones seem to be an accessible and affordable technology used in daily life of persons with stroke and family members and connects them to the needed services and social relationships. The mobile phone technology reduces resource and infrastructural challenges and increases accessibility to rehabilitation interventions. The mobile phone was an important instrument that facilitated the quality of life of persons with stroke and their family members and could increase their participation in rehabilitation interventions.

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Section: Family-centerednessmentioning

confidence: 99%

“…Study IV was a feasibility trial of a mobile phone supported family-centre ADL intervention, and was done as a prototype of the CADL model that was previously implemented in Sweden (58). Before starting the trial, a logic model was drawn up detailing the process and the content of the model (62).…”

Section: Processmentioning

confidence: 99%

Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

Kamwesiga

Tham

Guidetti

2016

Disability and Rehabilitation

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“…This study was performed in the context of a cluster randomized controlled trial 11,12,16 in which no significant difference in outcomes between a client-centred activities of daily living (ADL) intervention and usual ADL interventions was found. The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters.…”

Section: Introductionmentioning

confidence: 99%

Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

et al. 2016

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Objective:The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters.Design:Comparison of medical records.Setting:The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group.Subjects:Occupational therapist documentation in medical records of 279 clients with stroke.Main measures:The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness.Results:Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity.Conclusion:Documentation of goal setting and client participation in goal setting can be influenced by training.

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“…The intention with the thesis is also to contribute to develop strategies for implementing complex interventions in healthcare. The two studies are a part of a larger project LAS II (Life After Stroke) in which persons with stroke participated in a randomized control study (RCT) evaluating client-centred activities of daily living (ADL) intervention (CADL) after stroke compared with usual ADL (UADL) (2)(3)(4). The intervention was implemented by experienced OTs invited to participate in a workshop before the implementation phase.…”

Section: Introductionmentioning

confidence: 99%

Occupational therapists experiences of implementing a new complex intervention in collaboration with researchers: a qualitative longitudinal study

Eriksson

Erikson

Tham

et al. 2016

Scandinavian Journal of Occupational Therapy

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A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: one year follow-up of caregivers

Abstract: The client-centred intervention did not bring about any difference between caregiver-groups, but within groups some difference was found for caregiver burden and informal care.

Cited by 21 publications

References 37 publications

Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

Experiences of using mobile phones in everyday life among persons with stroke and their families in Uganda – a qualitative study

Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

Occupational therapists experiences of implementing a new complex intervention in collaboration with researchers: a qualitative longitudinal study

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