Caring for caregivers after a stroke

Ski, Chantal F.; Lautenschlager, Nicola T.; Moore, Gaye

doi:10.1017/s1041610214002385

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…Our finding that use was generally lower in higher ages (Tables 2 and 3 ) is in accordance with studies from Norway [ 41 ] and other countries [ 7 , 10 , 12 , 42 , 43 ]. It is consistently reported that older adults (55–65 years and over) of both genders are less likely than younger and middle aged to perceive a need for care, to receive referrals from primary care, and to use specialist psychiatric services [ 10 , 43 ]. In older adults visits to the GP for mental health problems seem to be more common than specialist visits [ 13 ].…”

Section: Discussionsupporting

confidence: 92%

Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey

Hansen

Høye

2015

BMC Health Serv Res

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BackgroundOverall, men are less likely than women to seek health care services for mental health problems, but differences between genders in higher age groups are equivocal. The aim of the current study was to investigate the association between gender and the use of psychiatric outpatient specialist services in Norway, both in a general population and in a subpopulation with self-reported anxiety and/or depression.MethodsUsing questionnaires from 12,982 participants (30–87 years) in the cross-sectional sixth Tromsø Study (2007-8) we estimated proportions reporting anxiety/depression, and proportions using psychiatric outpatient specialist services in a year. By logistic regressions we studied the association between gender and the use of psychiatric outpatient specialist services. Analyses were adjusted for age, marital status, income, education, self-reported degree of anxiety/depression, and GP visits last year. Analyses were also performed for genders separately.ResultsAnxiety/depression was reported by 21.5 % of women and 12.3 % of men in the general population. Visits to psychiatric outpatient services during one year were reported by 4.6 % of women and 3.3 % of men. The general population’s probability of a visit was significantly lower among men compared to women in ages 30–49 years (odds ratio [OR] 0.58, confidence interval [CI] 0.39–0.84, p-value [p] = 0.004), whereas men used services slightly more than women in ages 50 years and over (OR 1.36, CI 1.00–1.83, p = 0.047). Among those with anxiety/depression 13.5 % of women and 10.5 % of men visited psychiatric outpatient services in a year. We found no statistically significant gender differences in the use of services in this subgroup. Other factors associated with services use in women with anxiety/depression were higher education, more severe anxiety/depression, and GP visits the last year, whereas in men only a more severe anxiety/depression was associated with psychiatric outpatient visits. Overall, the use of services decreased with higher age.ConclusionsMost people with self-reported anxiety/depression did not visit specialist outpatient clinics. This applies in particular to men aged 30–49 years, older individuals, and individuals with lower education. Gender differences in the use of services in the general population were dependent on age, whereas in the subgroup with anxiety/depression gender differences were not confirmed.

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Section: Discussionsupporting

confidence: 92%

Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey

Hansen

Høye

2015

BMC Health Serv Res

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“…With the intention of enhancing self-efficacy, self-management, care co-ordination and quality of life, the OHP has been adapted within the broader context of chronic disease. Thus, in the current series of trials our OHP is used to implement this therapeutic framework to enable clinicians and consumers to work systematically towards the achievement of optimal psychosocial health outcomes within mainstream health services [ 23 ]. The self-management foundations of the OHP are particularly relevant for adults affected by stroke and their carers who face the daily challenge of managing various and often simultaneous aspects of their disease such as managing multiple medications, cognitive training, ongoing appointments, and physiotherapy as well as coping with the emotional impact of stroke and their care regimen.…”

Section: Introductionmentioning

confidence: 99%

The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial

Brasier

Ski

Thompson

et al. 2016

Trials

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BackgroundStroke is a leading cause of disability and distress, and often profoundly affects the quality of life of stroke survivors and their carers. With the support of carers, many stroke survivors are returning to live in the community despite the presence of disability and ongoing challenges. The sudden and catastrophic changes caused by stroke affects the mental, emotional and social health of both stroke survivors and carers. The aim of this study is to evaluate a Stroke and Carer Optimal Health Program (SCOHP) that adopts a person-centred approach and engages collaborative therapy to educate, support and improve the psychosocial health of stroke survivors and their carers.MethodsThis study is a prospective randomised controlled trial. It will include a total of 168 stroke survivors and carers randomly allocated into an intervention group (SCOHP) or a control group (usual care). Participants randomised to the intervention group will receive nine (8 + 1 booster) sessions guided by a structured workbook. The primary outcome measures for stroke survivors and carers will be health-related quality of life (AQoL-6D and EQ-5D) and self-efficacy (GSE). Secondary outcome measures will include: anxiety and depression (HADS); coping (Brief COPE); work and social adjustment (WSAS); carer strain (MCSI); carer satisfaction (CASI); and treatment evaluation (TEI-SF and CEQ). Process evaluation and a health economic cost analysis will also be conducted.DiscussionWe believe that this is an innovative intervention that engages the stroke survivor and carer and will be significant in improving the psychosocial health, increasing independence and reducing treatment-related costs in this vulnerable patient-carer dyad. In addition, we expect that the intervention will assist carers and stroke survivors to negotiate the complexity of health services across the trajectory of care and provide practical skills to improve self-management.Trial registrationACTRN12615001046594. Registered on 7 October 2015.

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“…Leaving the exposure to solvents as a causal explanation for the neuropsychological impairment of CSE-patients out of consideration, one could state that the CSE-patients identified at first diagnosis are in fact patients with non-amnestic mild cognitive impairment (MCI) (Petersen 2016 ; Gerstenecker and Mast 2014 ). Mild cognitive impairment is found in the aging population.…”

Section: Discussionmentioning

confidence: 99%

Chronic solvent-induced encephalopathy: course and prognostic factors of neuropsychological functioning

Valen

Wekking

Hout

et al. 2018

Int Arch Occup Environ Health

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PurposeWorking in conditions with daily exposure to organic solvents for many years can result in a disease known as chronic solvent-induced encephalopathy (CSE). The aims for this study were to describe the neuropsychological course of CSE after first diagnosis and to detect prognostic factors for neuropsychological impairment after diagnosis.MethodsThis prospective study follows a Dutch cohort of CSE patients who were first diagnosed between 2001 and 2011 and underwent a second neuropsychological assessment 1.5–2 years later. Cognitive subdomains were assessed and an overall cognitive impairment score was calculated. Paired t tests and multivariate linear regression analyses were performed to describe the neuropsychological course and to obtain prognostic factors for the neuropsychological functioning at follow-up.ResultsThere was a significant improvement on neuropsychological subdomains at follow-up, with effect sizes between small and medium (Cohen’s d 0.27–0.54) and a significant overall improvement of neuropsychological impairment with a medium effect size (Cohen’s d 0.56). Prognostic variables for more neuropsychological impairment at follow-up were a higher level of neuropsychological impairment at diagnosis and having a comorbid diagnosis of a psychiatric disorder at diagnosis.ConclusionsResults are in line with previous research on the course of CSE, stating that CSE is a non-progressive disease after cessation of exposure. However, during follow-up the percentage patients with permanent work disability pension increased from 14 to 37%. Preventive action is needed in countries where exposure to organic solvents is still high to prevent new cases of CSE.Electronic supplementary materialThe online version of this article (10.1007/s00420-018-1328-1) contains supplementary material, which is available to authorized users.

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Caring for caregivers after a stroke

Cited by 21 publications

References 23 publications

Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey

Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey

The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial

Chronic solvent-induced encephalopathy: course and prognostic factors of neuropsychological functioning

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