Stroke survivors’ experiences transitioning from hospital to home

Connolly, Teresa; Mahoney, Ellen

doi:10.1111/jocn.14563

Cited by 60 publications

(48 citation statements)

References 35 publications

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“…When examining the sociodemographic variables, we found that the study sample was similar to that of other studies, in which men at the transition from adulthood to older adulthood with low level of education were predominant (Benjamin et al, 2019; Connolly & Mahoney, 2018; Hebel, Bieniaszewski, & Kowalewski, 2014; Liu & Lou, 2019). Furthermore, we found similarities with regard to the clinical data, for which we observed a history of hypertension and TIA, the presence of ischemic stroke as the primary stroke type, low disease severity at discharge according to the NIHSS and low current functional impairment (Benjamin et al, 2019; Connolly & Mahoney, 2018; Hebel et al, 2014).…”

Section: Discussionsupporting

confidence: 78%

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

et al. 2019

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To clinically validate the defining characteristics of nursing diagnoses related to self-care deficits in feeding, bathing, toileting, and dressing in patients with stroke. A diagnostic accuracy study was conducted with a sample of 135 patients with stroke. Sensitivity and specificity were calculated based on the latent class analysis method using the random effects model. The prevalence of diagnoses was 23.5% for Bathing self-care deficit, 18.5% for Dressing self-care deficit, 13.3% for Toileting self-care deficit, and 7.5% for Feeding self-care deficit. Fourteen defining characteristics were sensitive, and 17 were specific. Hemorrhagic stroke and note 4 on the Rankin scale was associated with self-care deficits. Of the 37 defining characteristics of the four diagnoses studied, 19 were clinically validated according to the latent class analysis model. These most accurate clinical indicators contribute to the development of the care plan for patients with stroke.

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Section: Discussionsupporting

confidence: 78%

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

et al. 2019

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“…In this cohort, it is likely that post-stroke cognitive impairment, new physical disability and the recent transition home contributed to these reduced scores. This finding supports the need for ongoing intensive home-based rehabilitation post stroke during periods of challenge and adaptation (Connolly and Mahoney, 2018;Winstein et al, 2016). The high proportion of accuracy errors compared to the other error types indicated that participants were able to perform the key steps of the task but had difficulty applying cognitive strategies to do so effectively.…”

Section: Discussionsupporting

confidence: 65%

“…After the protection and structure of the hospital environment, the transition home can be a challenging period for the stroke survivor and their family (van der Wijst et al, 2014;Winstein et al, 2016) due to the dynamic home environment and subsequent increased demands on cognitive strategy application (Burns and Neville, 2016;Stigen et al, 2019). Whilst identifying advantages of ESD and the home environment (Lou et al, 2017), stroke survivors have also reported challenges with transition home due to incongruency between anticipated and real level of occupational performance and cognition (Connolly and Mahoney, 2018;Lou et al, 2017). This cognitive challenge may be magnified by shorter inpatient length of stays (Chouliara et al, 2014), stroke survivors not receiving standardised cognitive assessment during their inpatient admission and hospital-based assessments being a poor predictor of real-world performance (Morrison et al, 2015;Pilegaard et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Stroke survivors’ occupational performance and cognitive strategy use: A pilot exploration of strengths and difficulties using the Perceive Recall Plan Perform System of Task Analysis

White

Nott

Barr

et al. 2020

British Journal of Occupational Therapy

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Introduction The Perceive Recall Plan Perform System of Task Analysis is an ecological assessment of occupational performance and cognitive strategy application. This study aimed to describe occupational performance and cognitive strategies of stroke survivors in an early supported discharge service, compare the assessment with global measures of function and evaluate the feasibility of implementing the assessment in the early supported discharge setting. Method This study was a pilot study design and used consecutive sampling. Participants were assessed with the Perceive Recall Plan Perform System of Task Analysis and two global measures: the Functional Independence Measure and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale. Scores from the Perceive Recall Plan Perform System of Task Analysis were analysed by task mastery, sub-quadrants and quadrants, and correlations between the assessment and global measures were examined. Findings In this cohort ( n = 10), the Perceive Recall Plan Perform System of Task Analysis assessment required 47 minutes per task and identified reduced task mastery (mean = 55%, SD = 10%) with common difficulties in the perceive and plan domains. High to moderate correlations were identified between the plan quadrant and global measures ( p < 0.05). Conclusion Perceive Recall Plan Perform System of Task Analysis assessment can be successfully implemented by occupational therapists with stroke survivors receiving early supported discharge to measure occupational performance and identify strengths and difficulties in cognitive strategy application.

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“…It often leads to lifelong critical disability [1]. All stroke survivors are at risk of complications during recovery, regardless of stroke severity [2]. Patients' initial experiences after the onset of stroke are well described in various studies [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Gateway to Recovery: A Comparative Analysis of Stroke Patients’ Experiences of Change and Learning in Norway and Denmark

Pallesen

Aadal

Moe

et al. 2019

Rehabilitation Research and Practice

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Objectives The recovery process is reported by stroke survivors to be a change process fraught with crises and hazard. Interaction with health professionals and others may play a central role in establishing renewed control over life. Research Questions (1) How do patients handle and overcome experienced changes after stroke? (2) How do they experience the support to handle these changes during the first year after stroke? (3) How do the similarities and differences transpire in Danish and Norwegian contexts? Methodology. A qualitative method was chosen. Six patients from Denmark and five patients from Norway (aged 25-66) were followed up until one year after stroke, by way of individual interviews. The data were analyzed (using NVivo 11) by means of phenomenological analysis. Findings The participants described four main issues in the recovery process that impacted the experienced changes: (i) strategies and personal factors that promote motivation, (ii) the involvement of family, social network, and peers, (iii) professionals' support, and (iv) social structures that limit the recovery process. There was a diversity of professional support and some interesting variations in findings about factors that affected recovery and the ability to manage a new life situation between Central Denmark and Northern Norway. Both Norwegian and Danish participants experienced positive changes and progress on the bodily level, as well as in terms of activity and participation. Furthermore, they learned how to overcome limitations, especially in bodily functions and daily activities at home. Unfortunately, progress or support related to psychosocial rehabilitation was almost absent in the Norwegian data.

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Stroke survivors’ experiences transitioning from hospital to home

Cited by 60 publications

References 35 publications

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

Stroke survivors’ occupational performance and cognitive strategy use: A pilot exploration of strengths and difficulties using the Perceive Recall Plan Perform System of Task Analysis

Gateway to Recovery: A Comparative Analysis of Stroke Patients’ Experiences of Change and Learning in Norway and Denmark

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