Client-centred ADL intervention after stroke: Significant others’ experiences

Bertilsson, Ann-Sofie; Koch, Lena von; Tham, Kerstin; Johansson, Ulla

doi:10.3109/11038128.2015.1044561

Cited by 14 publications

(15 citation statements)

References 32 publications

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“…The four studies in this thesis evaluate a complex intervention through different perspectives and methods. The various studies, taken together with other studies in this research project (31,71,88,108,109) , provide new knowledge in the context of a client-centred ADL intervention. In this thesis, two of the studies (Study I and II) were designed to compare the effects of the CADL to those of the UADL in the primary outcome "participation" (SIS domain eight) and secondary outcomes during one year.…”

Section: Evaluating Complex Interventionsmentioning

confidence: 98%

“…In a recently published study of dyads in stroke (70), the caregivers reported taking greater responsibility for household chores and needing to take more initiatives and responsibility for safety, planning and creating routines for everyday life. However, another study (71) showed that when people with stroke acted as agents in their daily activities, it also influenced the significant others in their interaction and seemed to support the significant others who "took responsibility and achieved a balance with respect to self-esteem in order to get on with everyday life".…”

Section: Significant Othersinformal Care and Caregiver Burdenmentioning

confidence: 99%

“…The clients acting as agents has also shown to influence the significant others where a transfer of learning from the CADL to everyday life situations was shared with the significant others (71). A possible gain would be that the significant other would experience a lower caregiver burden if the client experienced the ownership of his/her daily activities and therapeutic process.…”

Section: The Client As the Owner Of The Therapeutic Processmentioning

confidence: 99%

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Client-centred ADL intervention after stroke: Occupational therapists’ experiences

Ranner

Koch

Guidetti

et al. 2015

Scandinavian Journal of Occupational Therapy

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Section: Evaluating Complex Interventionsmentioning

confidence: 98%

Section: Significant Othersinformal Care and Caregiver Burdenmentioning

confidence: 99%

Section: The Client As the Owner Of The Therapeutic Processmentioning

confidence: 99%

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Client-centred ADL intervention after stroke: Occupational therapists’ experiences

Ranner

Koch

Guidetti

et al. 2015

Scandinavian Journal of Occupational Therapy

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“…Stroke can lead to a stressful situation for family members, with restricted participation, reduced life satisfaction and perceived burden among caregivers [ 6 , 7 ]. A general aim for most rehabilitation programmes for people with stroke is, therefore, to involve the persons’ family in order to attain maximum participation in activities in daily living (ADL) [ 8 ]. Contemporary theories have been confirmed in empirical studies in rehabilitation after stroke, and have shown strong evidence of positive effects of ADL interventions [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

A feasibility study of a mobile phone supported family-centred ADL intervention, F@ce™, after stroke in Uganda

et al. 2018

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BackgroundThere is a lack of evidence-based health services to reduce the impact of stroke in low-income countries at a personal, family or community level.The aim was to evaluate the feasibility of: i) a mobile phone supported family-centred intervention (F@ce™), and ii) the study design for evaluating the effects of the intervention on the perceived impact of stroke; perceived participation in everyday life; and self-efficacy in everyday activities amongst persons with stroke and their families in Uganda.MethodsThe study comprised a pre-post design with an intervention group (IG) receiving the F@ce™ and a control group (CG). The inclusion criteria’s were: a) confirmed stroke diagnosis, b) access to and ability to use a mobile phone, c) ability to communicate in English and/or Luganda, d) > 18 years, e) residents in Kampala, and f) a Modified Rankin Scale level 2 to 4.The aim of the F@ceTM was to increase functioning in daily activities for persons living with the consequences of stroke, and participation in everyday life for persons with stroke and their families. The F@ce™ was an eight-week family-centred intervention, which entailed goal setting and problem-solving strategies, daily reminders and self-rated follow-ups of performance by short message service (SMS).Data were collected in the participants’ home environment at baseline and after eight weeks. Data on acceptability of the F@ce™ and study procedures were collected by log-books and the responses of the SMS follow ups on the server. The primary outcomes were performance and satisfaction of valued daily activities in everyday life using the Canadian Occupational Performance Measure (COPM), self-efficacy in performance of activities in daily life.ResultsThe IG comprised n = 13 and the CG n = 15. There were differences between the IG and CG in changes between baseline and follow-up in the primary outcomes COPM (performance component) and self-efficacy in favour of F@ce™. Overall with minor modifications the intervention and the study design were feasible for all participants involved.ConclusionThe results support the need for further research to rigorously evaluate the effects of F@ce™ since the intervention appears to be feasible for persons with stroke and their family members.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0400-7) contains supplementary material, which is available to authorized users.

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“…A systematic review of the situation of informal caregivers vis-à-vis patients who have had a stroke has shown increased and additional responsibilities for caregivers, leading to decreased time for leisure and paid work [30]. Being an informal caregiver thus may affect the caregiver’s own health [31, 32]. …”

Section: Discussionmentioning

confidence: 99%

The case of value-based healthcare for people living with complex long-term conditions

Elf

Flink

Nilsson

et al. 2017

BMC Health Serv Res

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BackgroundThere is a trend towards value-based health service, striving to cut costs while generating value for the patient. The overall objective comprises higher-quality health services and improved patient safety and cost efficiency. The approach could align with patient-centred care, as it entails a focus on the patient’s experience of her or his entire cycle of care, including the use of well-defined outcome measurements. Challenges arise when the approach is applied to health services for people living with long-term complex conditions that require support from various healthcare services. The aim of this work is to critically discuss the value-based approach and its implications for patients with long-term complex conditions. Two cases from clinical practice and research form the foundation for our reasoning, illustrating several challenges regarding value-based health services for people living with long-term complex conditions.DiscussionAchieving value-based health services that provide the health outcomes that matter to patients and providing greater patient-centredness will place increased demands on the healthcare system. Patients and their informal caregivers must be included in the development and establishment of outcome measures. The outcome measures must be standardized to allow evaluation of specific conditions at an aggregated level, but they must also be sensitive enough to capture each patient’s individual needs and goals. Healthcare systems that strive to establish value-based services must collaborate beyond the organizational boundaries to create clear patient trajectories in order to avoid fragmentation.SummaryThe shift towards value-based health services has the potential to align healthcare-service delivery with patient-centred care if serious efforts to take the patient’s perspective into account are made. This is especially challenging in fragmented healthcare systems and for patients with long-term- and multi-setting-care needs.

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Client-centred ADL intervention after stroke: Significant others’ experiences

Abstract: Enablement is important also for the significant others of people with stroke. One way of enabling significant others to maintain an active lifestyle and find respite in everyday life might be to enable people with stroke to formulate and act upon their desired activity goals.

Cited by 14 publications

References 32 publications

Client-centred ADL intervention after stroke: Occupational therapists’ experiences

Client-centred ADL intervention after stroke: Occupational therapists’ experiences

A feasibility study of a mobile phone supported family-centred ADL intervention, F@ce™, after stroke in Uganda

The case of value-based healthcare for people living with complex long-term conditions

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