Actual vs best practice for families post-stroke according to three rehabilitation disciplines

Rochette, Annie; Korner‐Bitensky, Nicol; Desrosiers, Johanne

doi:10.2340/16501977-0082

Cited by 41 publications

(34 citation statements)

References 34 publications

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“…Consequently we conducted a systematic review to investigate the types and effectiveness of interventions studied that are aimed at increasing knowledge about, attitudes towards, and use of standardized outcome measures in the core (19) …”

Section: Introductionmentioning

confidence: 99%

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

et al. 2016

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Abstract:Objective: To determine the types and effectiveness of interventions to increase the knowledge about, attitudes towards, and use of standardized outcome measures in rehabilitation professionals. Data Sources: An electronic search using Medline, EMBASE, PsycINFO, CINAHL, Ergonomics Abstracts, Sports Discus. The search is current to February 2016. Study Selection: All study designs testing interventions were included as were all provider and patient types. Two reviewers independently conducted a title and abstract review, followed by a full-text review. Data extraction: Two reviewers independently extracted a priori variables and used consensus for disagreements. Quality assessment was conducted using the Assessment of Quantitative Studies published by the Effective Public Health Practice Group. Data Synthesis: We identified 11 studies involving at least 1200 providers. Nine of the studies showed improvements in outcome measure use rates but only three of these studies used an experimental or quasi-experimental design. Eight of the studies used an educational approach in the intervention and three used audit and feedback. Poor intervention description and quality of studies limited recommendations. Conclusions: Increased attention to testing interventions focused on known barriers, matched to behavior change techniques, and with stronger designs is warranted. We identified 11 studies involving at least 1200 providers. Nine of the studies showed improvements in outcome measure use rates but only three of these studies used an experimental or quasi-experimental design. Eight of the studies used an educational approach in the intervention and three used audit and feedback. Poor intervention description and quality of studies limited recommendations. Conclusions: Increased attention to testing interventions focused on known barriers, matched to behavior change techniques, and with stronger designs is warranted.

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Section: Introductionmentioning

confidence: 99%

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

et al. 2016

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“…The study also discovered that negative influences on screening included feeling uncomfortable using standardised multi-item questionnaires, and perceiving that screening was not a useful clinical activity because it failed to provide information that helped with the selection of treatments. These findings have been echoed in other studies looking at the implementation of stroke rehabilitation evidence into guidelines [22,23] , and prompted the authors of the current paper to investigate alternatives to questionnaire methods of screening for post-stroke psychological distress. We specifically sought an alternative that was brief, low-cost, tailored -or able to be tailored -to individuals with stroke, and that would allow the results of screening to be linked to treatment options in a more obvious way.…”

Section: Introductionmentioning

confidence: 80%

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Gillespie

Cadden

2013

JNEP

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Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke.Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant barriers to the implementation of post-stroke mood and psychological distress screening programmes. One barrier relates to limitations of questionnaire methods for identifying distress. Specifically, existing mood questionnaires are often too lengthy; miss important emotional changes that result from stroke; and do not necessarily point nurses towards the most helpful intervention approaches. Methods:We sought to develop a brief, clinically valid screening system that could be used by nurses to identify the levels of psychological distress experienced by stroke survivors. As well as determining levels of distress, the system was intended to aid the identification of first-line interventions that nurses could offer to alleviate distress.Results: A screening system was identified from the oncology literature (the Distress Management System [DMS]) that appeared to meet the broad requirements for screening for stroke-related distress. To tailor the DMS for stroke settings, we obtained feedback on the components of the DMS from stroke survivors and stroke nurses, and also consulted the research literature. This led us to: (1) retain the distress screening component of the DMS, the 'Distress Thermometer'; (2) modify the DMS's 'Concerns Checklist' to reflect the main problems encountered after stroke; and (3) add a 'Resource Pack' to the screening system to enable nurses to offer first-line interventions targeted at individuals' distress. The result, the Distress Management System for Stroke (DMSS), is presented in full in this paper. Conclusion:The DMSS is a potentially useful tool for nurses working in stroke settings. It is brief, straightforward to administer, captures the main emotional concerns of stroke survivors, and the findings from the DMSS can be used to structure interventions for psychological distress. Future work is required, however, to establish the DMSS's reliability, validity and clinical effectiveness.

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“…Finally, we realize that 'standard' practice, as indicated by the most common survey responses, is not always synonymous with the 'best' practice. 23 Therefore, although standard practice in the Intermountain Healthcare NICU system is to discard blood-tinged milk, we maintain that more study is needed before that practice can be endorsed as best.…”

Section: Discussionmentioning

confidence: 95%

Attitudes of NICU professionals regarding feeding blood-tinged colostrum or milk

et al. 2009

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Objective: Mothers of neonatal intensive care unit (NICU) patients sometimes bring expressed milk that is blood tinged to the NICU. In certain instances, the blood contamination appears minimal, whereas in others, the milk is quite dark pink. We have observed inconsistencies in practice regarding whether or not to feed blood-tinged colostrum or milk to NICU patients. We know of no evidence that establishes best practice in this area, and thus we sought to determine attitudes of NICU professionals on which to base a potentially best practice.Study Design: We conducted a web-based anonymous survey of attitudes of NICU professionals at Intermountain Healthcare regarding feeding blood-tinged expressed milk to NICU patients. These professionals included neonatologists, neonatal nurse practitioners, NICU nurses, NICU dieticians and lactation consultants.Result: Survey results were returned from 64% (426 of 667) of those to whom it was sent. A total of 75% of respondents reported that their practice was NOT to feed the blood-tinged milk illustrated in the figure as sample 2, and nearly all respondents (98%) reported that they would NOT feed the milk illustrated as sample 3. The majority of the neonatologists (56%) and the lactation consultants (58%) recommended feeding moderately bloody milk (sample 2), whereas only 22% of the neonatal nurse practitioners (NNPs), NICU nurses and NICU dieticians recommended feeding such samples (<0.001). The most frequently selected reason for NOT feeding blood-tinged milk was that it would likely cause gastrointestinal upset and feeding intolerance (selected by 77%). The majority (87%) overestimated the amount of blood contaminating a milk sample (sample 3). Conclusion:As colostrum and human milk feedings can be of value to NICU patients, evidence should be assembled to document whether feeding blood-tinged samples indeed have the problems listed by the survey respondents. Such evidence is needed to enable informed decisions involving the benefits vs risks of feeding blood-tinged expressed milk to NICU patients.

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Actual vs best practice for families post-stroke according to three rehabilitation disciplines

Abstract: For these 3 disciplines, the prevalence of a family-related focus is low post-stroke. Given the increasing evidence regarding the effectiveness of family-related interventions on stroke outcomes, it is imperative that best practice is implemented.

Cited by 41 publications

References 34 publications

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Attitudes of NICU professionals regarding feeding blood-tinged colostrum or milk

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