Understanding Hope After Stroke: A Systematic Review of the Literature Using Concept Analysis

Bright, Felicity; Kayes, Nicola; McCann, Clare; McPherson, Kathryn

doi:10.1310/tsr1805-490

Cited by 62 publications

(73 citation statements)

References 50 publications

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“…[18,40] Bright, et al, defined hope as an inner strength, being positive in nature and included patients' wishes to return to a normal way of life, normal roles, and normal activities. [20] This is comparable with participants in the current study as they discussed reliance on their own inner strengths to return to their lives prior to the stroke. This element of hope is comparable to resilience, which enhances both physical health and quality of life in older adults.…”

Section: Hope and Uncertaintysupporting

confidence: 73%

“…An interview schedule was developed from published phenomenological research within stroke and intensive care settings. [18][19][20] The interview schedule was then pilot tested with a clinical nurse specialist and a patient currently in hospital following a stroke. Following the pilot test one question was altered from "What impact do you think your stroke will have on your future?"…”

Section: Data Collectionmentioning

confidence: 99%

“…Participants in the current study expressed the importance of family and social support. [43] The model of hope after stroke [20] is an important working definition of hope, which will allow patients with less hope in the acute phase to be identified and provided with appropriate support from healthcare professionals.…”

Section: Hope and Uncertaintymentioning

confidence: 99%

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Rebuilding and restructuring the world following rapid comprehensive assessment and treatment for an acute stroke

Brooke

2015

Clinical Nursing Studies

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Management of acute stroke has changed through implementation of rapid comprehensive assessment and treatment. Stroke as a medical emergency and expectancy of recovery has implications on how patients cognitively process the impact of their stroke. Current literature focuses on long term recovery and little is known about patients' experiences and cognitive processing during the acute phase. Semi-structured interviews were completed with 6 patients on a stroke unit, London, UK, between October and December 2012. The interview schedule was based on interviews with a clinical nurse specialist, stroke patient and previous literature. Interviews took place during hospital admission following transfer from a hyper acute stroke unit. Data were analysed using Interpretative Phenomenological Analysis. Participants ages ranged from 68 to 94 years, the emergent super-ordinate themes from this sample receiving a diagnosis of an acute stroke included: (1) disassociation from bodies, self and abilities; (2) search for understanding; (3) striving for independence and acceptance of support; and (4) hope and uncertainty. Although there were variations in participants' experiences these themes capture the experience of the participants collectively. All participants applied cognitive processes to commence the rebuilding and restructuring of their world. Participants began this process in the acute stage of their stroke.

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Section: Hope and Uncertaintysupporting

confidence: 73%

Section: Data Collectionmentioning

confidence: 99%

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Rebuilding and restructuring the world following rapid comprehensive assessment and treatment for an acute stroke

Brooke

2015

Clinical Nursing Studies

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“…This process facilitated close examination of definitions and characteristics of engagement and the process, outcomes and behaviors associated with engagement. The findings were recorded using matrices which facilitated comparison within and between articles [17,20]. Core themes were extracted and refined using a process of constant comparison [21] in order to synthesize data.…”

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confidence: 99%

A conceptual review of engagement in healthcare and rehabilitation

Bright

Kayes

Worrall

et al. 2014

Disability and Rehabilitation

188

177

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A conceptual review of engagement in healthcare and rehabilitationPurpose: This review sought to develop an understanding of how engagement in healthcare has been conceptualized in the literature in order to inform future clinical practice and research in rehabilitation. A secondary purpose was to propose a working definition of engagement.Method: EBSCO and SCOPUS databases and reference lists were searched for papers that sought to understand or describe the concept of engagement in healthcare or reported the development of a measure of engagement in healthcare. We drew on a Pragmatic Utility approach to concept analysis.Results: Thirty-one articles met the criteria and were included in the review. Engagement appeared to be conceptualized in two inter-connected ways: as a gradual process of connection between the healthcare provider and patient; and as an internal state which may be accompanied by observable behaviors indicating engagement. Conclusion:Our review suggests engagement to be multi-dimensional, comprising both a coconstructed process and a patient state. While engagement is commonly considered a patient behavior, the review findings suggest clinicians play a pivotal role in patient engagement. This review challenges some understandings of engagement and how we work with patients, and highlights conceptual limitations of some measures. Introduction'Patient engagement' is a term increasingly used in rehabilitation and the broader healthcare context [1]. Several authors have argued the benefits of rehabilitation are limited if the patient is not fully engaged in the process [2,3]. For example, levels of engagement have been associated with improved functional improvement during inpatient rehabilitation and levels of functioning after discharge. Levels of engagement have also been associated with lower levels of depression and with higher levels of affect, adherence and attendance [2,4]. In addition, within clinical rehabilitation practice, the 'engaged patient' is perhaps identified as being the 'desirable patient', one who is easy for providers to work with [5]. On the face of it, these findings suggest that patient engagement is both positive and desirable.While the term 'engagement' is increasingly used in clinical practice and research, there has been relatively little critical exploration of what 'engagement' means and the underpinning concept/s the term may represent. Research of engagement appears to be in its early days, with little consensus on what engagement is, what leads to a patient being perceived as engaged or disengaged or indeed, how engagement occurs. The term engagement is used in multiple ways in the literature, variably referring to patient actions and behaviors such as accessing services [6], retention within services [7,8], enthusiasm [2] and self-management of health conditions [8], or referred to a hospital's provision of health resources and social media usage [9], and to the interaction between the patient and healthcare provider [10].It could be argued that it does not matt...

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“…Although hope is essential for coping and adjustment for individuals with ABI and their family members (Bright, Kayes, McCann, & McPherson, 2011;Kuipers et al, 2014;Rushworth, 2015), the challenge for clinicians is to balance this with the possibility of a long duration or permanent driving disruption. In aligning families' expectations, clinicians may facilitate family members to employ long-term and feasible management strategies.…”

Section: Discussionmentioning

confidence: 99%

Family members’ needs and experiences related to driving disruption following acquired brain injury

Liang¹

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Family members often assume the caregiving role after an individual sustains an acquired brain injury (ABI). A mandated period of driving disruption following an ABI means that individuals will often rely heavily on family members for transport and emotional support.However, research on driving disruption has largely focused on the impact, assessment and rehabilitation of the individual with ABI, with little attention given to family members. In order to develop an understanding for approaches to support family members better, this thesis aimed to explore the needs and experiences of family members during driving disruption following an ABI.The first aim of the thesis was to gain a broader understanding of the issue by conducting a scoping review of the literature on family members' needs and experiences during driving disruption across all health conditions. The scoping review found that driving disruption is a stressful and complex issue with communication and emotional implications for family members. The review highlighted differences in experiences according to health condition, permanence of driving disruption and nature of the caregiver occupation, and identified the need for further research on the issue of driving disruption for family members of individuals with ABI.A prospective, mixed methods, longitudinal study, with a phenomenological approach was conducted with family members of individuals with ABI who were experiencing driving disruption. Recruitment was stratified according to time post-ABI to gain a range of perspectives. Data were collected from 15 family members at three time-points: recruitment to study, 3 and 6 months later. Self-report questionnaires measuring family members' quality of life and well-being were administered at the first time-point, and semistructured interviews were conducted at each time-point. All interviews incorporated the use of a map to elicit qualitative and quantitative data about family members' current travel patterns as a result of driving disruption. The data were analysed using different approaches in a series of four studies.The first two studies aimed to gain an in-depth understanding about the experiences of family members of individuals experiencing driving disruption due to ABI across the recovery continuum. Both studies examined the mixed methods cross-sectional data from the first time-point. The first study explored the differences in family members' experiences iii at the early (<1 year post-ABI) and later stages (>1 year post-ABI) using a mixed methods, phenomenological approach. Family members in the later group reported more challenges with greater intensity. These challenges included changes in everyday activities, the impact on their emotions, consequences for the whole family, and effects on physical health. The later group had lower ratings of health and well-being, and higher caregiver strain.The second study investigated the specific changes family members experienced in everyday activities with a focus on the impact of driving disru...

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Understanding Hope After Stroke: A Systematic Review of the Literature Using Concept Analysis

Abstract: This novel approach to analysis has furthered the understanding of hope. It has proposed a working model of hope that could be used by clinicians in considering hope with their clients and patients.

Cited by 62 publications

References 50 publications

Rebuilding and restructuring the world following rapid comprehensive assessment and treatment for an acute stroke

Rebuilding and restructuring the world following rapid comprehensive assessment and treatment for an acute stroke

A conceptual review of engagement in healthcare and rehabilitation

Family members’ needs and experiences related to driving disruption following acquired brain injury

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