Welcome to the WSC 2022 Interactive Program

Background and Aims

Too many people leave hospital with questions about their diagnosis, treatment they received and next steps for their care. These may be discussed in hospital, but stroke survivors tell us they are often overwhelmed at this point, with most attention focused on ‘getting home’, so they struggle to retain the information. We know the value stroke survivors place on feeling fully informed and involved in their care. We also know that having written, personalised information can help to optimise patient outcomes and experience of care and support, and patients are more likely to play an active role in their care and have a truly person-centred experience.

Methods

The Stroke Association UK worked with the Personalised Care Team at the National Health Service England on a new Personal Stroke Record, a template to be filled in together by a stroke survivor, their family, and a member of their acute stroke team before they leave hospital.

Local Integrated Stroke Delivery Networks may already be using something similar to the Personal Stroke Record as set out in the National Stroke Service Model. Where this isn’t happening, we will look to meet this need for access to personalised information.

Results

The template contains information people affected by stroke need (and want) to support their recovery, including information about the acute phase of their treatment and immediate next steps after leaving hospital.

Conclusions

Following implementation and evaluation, the scope could be expanded beyond the acute phase and next steps.

Background and Aims

Background and aims: Informal caregivers (ICGs) often lack knowledge and expertise to give required care. The purpose of this study therefore was to determine the effects of physiotherapy-based training and involvement of informal caregivers on physical functions of stroke survivors (SSs).

Methods

Methods: 71 dyads of IGCs and SSs, which is 142 participants, comprising 39 dyads in the study group (STG) and 32 dyads in the control group (CTG) completed the study. All ICGs in the STG had a structured training aimed at improving their care giving at home; The ICGs in the CTG had no structured training and were not involved in decision making for their care recipients. All the SSs in both groups received conventional physiotherapy. Barthel Index (BI) was used to evaluate the SSs at baseline and after the 12^thweek of study. Statistical analyses involved t-test, Chi-square, Mann-Whitney U, and Multivariate Regression. The level of significance was p˂ 0.05.

Results

Results: The most affected side of the body was the right side (53.5%): There was a higher significant change (p=0.001) in the BI score of the STG than that of the CTG. There was a positive relationship between age of ICGs and the scores of the SSs on the BI (ρ= 0.422), there was a significant relationship between the SSs’ BI score and ICGs’ relationship as spouse, in the combination of both groups (B= -23.906, p-value= 0.027).

Conclusions

Conclusions: Physiotherapy-based training and involvement of ICGs had significant effects on physical function of SSs.

Background and Aims

Chronic aphasia after stroke is linked to poor functional recovery, depression, and social isolation. In the exploration of the above factors, the role of aphasia communication groups has evolved. Aphasia communication groups for stroke survivors with chronic aphasia and their communication buddies are gaining clinical importance.

Methods

Communication buddies can be family members, friends, carers, health professionals and speech and language therapy students who serve as communication facilitators for each group member. Group members share experiences on stroke and aphasia by using technology/tablets and the total communication approach.

Results

The benefits or outcomes of group involvement are measured by assessment of functional communication, individual self-ratings of the impact of aphasia on communication and quality of life after stroke.

Conclusions

The use of the communication buddy system, total communication approach and systematic evaluations enables therapists to measure the effectiveness and efficacy of communication groups in terms of functional communication, social inclusion and quality of life.

Background and Aims

Stroke can dramatically affect a person’s life due to the sudden nature of the illness and the resulting disabilities. Measures to minimise the barriers that hinder social participation should be a major goal in stroke rehabilitation. This qualitative study aimed to explore the short- and long-term rehabilitation needs of stroke survivors in order to identify gaps in existing health services and better inform future interventions to facilitate ageing in place.

Methods

Convenience sampling was used to recruit 50 stroke survivors for the study. Semi-structured interviews were conducted to understand the post-discharge experiences of stroke survivors. Participants were asked about their individual recovery needs and their opinions on existing community health services. All interviews were audio-recorded and transcribed verbatim. Data were coded and analysed using content analysis.

Results

The majority of stroke survivors were aged 50 or above and were taken care of by family caregivers due to limited limb mobility. Regarding short-term needs, participants suggested that at-home support for conducting rehabilitation exercises and financial assistance were required. In terms of long-term needs, survivors wished for the installation of suitable public fitness equipment, increased accessibility, and home visits by medical volunteers to receive rehabilitation advice, guidance and supervision for physical exercise, and social and emotional support at home.

Conclusions

The findings further support that interventions offered in the course of rehabilitation should aim for in-home rehabilitation support upon hospital discharge. Apart from rehabilitation services focusing on restoring functional independence, promoting psychological and social aspects of recovery is crucial.

Background and Aims

Stroke rehabilitation use (SRU) improves immediate and longer-term functioning and quality of life. However, 67% of Singapore patients were not engaging in outpatient SRU sufficiently. Patient depression impedes SRU while holistic care and caregiver support facilitate its uptake. This study examined the mediating role of patient depression and caregiving burden and the moderating role of domestic help on the association between SRU at 3-month and 12-month post-stroke.

Methods

208 stroke patient-caregiver dyads from five tertiary hospitals provided data. Patient depression and caregiving burden were assessed by center for epidemiological studies-depression-11 and oberst caregiving burden scales respectively. Availability of domestic help for housework, and for stroke care, and SRU at both time points were dichotomous variables.

Results

Serial mediation analyses found that the association between SRU at 3-month and 12-month post-stroke was partially mediated by patient depression and then caregiving burden (effect = -0.10, Bootstrap 95% CI [-0.26, -0.01]). Moderated mediation analyses revealed that the above indirect effect was conditional upon the availability of domestic help for housework (index of moderated mediation = 0.11, SE = 0.11, Bootstrap 95% CI [0.003,0.400]). Simple slope analyses suggested that when domestic help was unavailable, patient depression was strongly associated with caregiving burden (β = 7.09, p < .001), and the serial mediation mechanism may weaken the overall positive association between SRU at 3-month and 12-month post-stroke (effect = -0.11, Bootstrap 95% CI [-0.28, -0.01]).

Conclusions

With unavailable domestic help, addressing patient depression and caregiving burden could increase SRU beyond 3 months.

Background and Aims

In 2021, Stroke Foundation launched Our Stroke Journey, an information resource for Aboriginal and Torres Strait Islander stroke survivors and families. Our Stroke Journey has everything people need to know to take their place at the centre of their care, look after their health, and live a good life after stroke.

This poster aims to engage clinicians with developing and delivering culturally appropriate resources for their settings, and improving clinical care.

Methods

Our Stroke Journey builds on the pioneering work of local resources for Aboriginal and Torres Strait Islander people across Australia.

The Queensland Aboriginal and Islander Health Council (QAIHC) led consultations, enabled a clear vision for the project and completed the design.

Aboriginal and Torres Strait survivors and families are highly aware of the impact of stroke in their communities. They were passionate about creating change and generous with their time, expertise and stories.

Aboriginal and Torres Strait Islander health organisations and workers, and health services and workers delivering services to Aboriginal and Torres Strait Islander communities provided advice on content, the design, engagement and distribution, and introduced us to other people who could be part of the collaboration.

Results

This poster will explore the reach and impact of Our Stroke Journey. It will highlight plans for further work and the impact on Stroke Foundation, including work on our first Reconciliation Action Plan.

Conclusions

Collaboration was at the heart of this project, allowing us to deliver a resource that responds to the needs and preferences of Aboriginal and Torres Strait Islander people.

Background and Aims

Young people with stroke(YPwS) persistently experience challenges with disability, social reintegration, employment and financial stability to provide for themselves and their families. The aims of this scoping review are to: 1)identify and collate information resources for YPwS and evidence-based self-managements programs and,2)identify gaps in age-specific resources available for YPwS after traditional rehabilitation services have ended and/or who are returning to live in the community.

Methods

We will include both qualitative and quantitative studies, including all study designs. Participants will be community-dwelling adults aged between 18–65 years with a clinical diagnosis of stroke. We will include information resources and evidence-based self-managements programs for YPwS. Search terms will include stroke, young people, community-dwelling. We will search electronic databases such as MEDLINE. The reference lists of included studies, systematic reviews and stroke guidelines and stroke specific websites will also be searched. We will also contact Stroke Support Organizations and international/national allied health professional organisations to gather information resources about YPwS. We will also conduct a comprehensive environmental scan of additional resources using the search engine Google.

The titles, abstracts, full-text articles and contents of the resources identified by the search will be assessed against the inclusion and exclusion criteria to identify potentially relevant resources.

Results

Existing resources and self-management programs will be collated and categorized according to the type of needs addressed such as physical, emotions, activities of daily living, information, relationships and social needs as well as the key gaps identified.

Conclusions

This study will review the information sources available to young people with stroke.

Background and Aims

Evidence shows that younger stroke survivors encounter greater difficulties resuming their pre-stroke social roles and activities compared to older adults. More evidence about their adjustments made when resuming social roles is needed. This study explored the experiences of adjusting to pre-stroke social roles among younger stroke survivors.

Methods

A qualitative study was conducted with a convenience sample of stroke survivors recruited from a support group. The survivors were under 65 years old, living at home and managing to resume their pre-stroke social roles. Survivors attended individual semi-structured interviews and were invited to share the changes in their social roles after stroke, how they adjusted to their expected social roles and satisfaction with their current social roles.

Results

Fifteen survivors were interviewed (mean age=55.20 years, SD=5.12). Most of them were male (67%), married (67%), walked with a stick or required a wheelchair (53%), and had a first-ever ischaemic stroke (53%) (mean duration after onset=96.00 months, SD=74.80). Only four (27%) retained a full-time job after stroke. Five themes were generated: Prioritising roles of family care or making a living; reducing role-related responsibilities and activities; building up mottos and strategies for troubleshooting; desiring for being acknowledged; and allowing time for self and others to accommodate the new roles.

Conclusions

The results highlighted the difficulties encountered by younger stroke survivors when resuming their pre-stroke social roles. Reduction in role-related responsibilities and activities were common. More age-appropriate interventions are needed to better assist younger stroke survivors in resuming their social roles.

Background and Aims

The rate of return to paid or unpaid work in young survivors was 66% only within four years after stroke. This paper presents the development of a user-informed, theory-driven inclusive volunteering intervention aimed to improve young stroke survivors’ work ability.

Methods

We adopted the three-step approach based on the Medical Research Council guidance to develop the intervention. A comprehensive literature review was conducted to examine the effects of interventions aimed to improve young stroke survivors’ work ability and the theoretical frameworks appropriate for understanding the mechanisms of changes in survivors’ work ability. We collected feedback from three young stroke survivors (45-58 years old) who resumed paid employment after stroke on helpful strategies to assist in securing jobs.

Results

A novel 6-week virtual inclusive volunteering programme grounded in Bandura’s principles of self-efficacy was developed to build young survivors’ work ability. Young survivors will volunteer with lay volunteers to promote peer survivors’ psychological well-being. The activities were designed to develop survivors’ confidence in collaborating with people without physical disabilities and adapting to real work environment gradually in a less stressful environment. They will be assisted to develop work-related, social and self-management skills during the activities. Involving lay volunteers in the activities will allow them to better understand the survivors’ needs.

Conclusions

A large-scale randomised controlled trial will be conducted to evaluate the effects of the intervention on young survivors’ work ability. We expect the intervention will facilitate survivors’ resumption of paid or unpaid work and foster social inclusion.

Background and Aims

Functional impairments post-stroke can lead to increased falls and decreased community participation. The professional-led Community Reintegration after Stroke (CREATE) program consisting of 7 weekly group sessions and 3-month follow-ups was developed for community-living stroke survivors and family caregivers in Singapore. This study aimed to test the acceptability and feasibility of the program.

Methods

Pre-post intervention study design was used. Stroke participants and family caregivers were recruited from two rehabilitation centres via purposive sampling. The recruitment process and attendance rate were recorded to test its feasibility. Fall incidence was collected during the study period. Data gathered from program evaluation questionnaires and interviews were analysed using content analysis to determine its acceptability. Graphs and descriptive statistics from pre-post evaluations were generated to visualize any trends.

Results

The overall recruitment and retention rates were 55% and 39% respectively. Eight stroke participants and 7 caregivers completed the program at two centres. All stroke participants achieved full attendance over the 7-week program but not the family caregivers (38%). All participants highlighted their acceptability of having a group-based program. Four stroke participants fell during the study period. Stroke participants demonstrated significant improvement in community participation at one-month post-intervention follow-up. Family caregivers had no reported changes in pre-post evaluations.

Conclusions

The CREATE program appears to be feasible and acceptable to therapists and service users in Singapore. However, the inclusion of caregivers was limited with recommendations for future changes. Findings can be used to further improve the program and its methodology before testing its effectiveness at a larger-scale trial.

Background and Aims

Recurrent stroke remains high and is associated with an increased risk of death. While there are a variety of community rehabilitation services, facilities, and volunteer support, the health-seeking behaviours of stroke survivors have a strong influence on their knowledge and use of such services. This study was conducted to explore the health-seeking behaviours and attitudes of Chinese stroke survivors.

Methods

Fifty stroke survivors were recruited for the study through convenience sampling and individual semi-structured interviews were conducted. Participants were asked about their health conditions post-stroke, rehabilitation and healthcare services used, and desired community health services. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the resulting data was carried out according to the method by Braun and Clarke (2006).

Results

Participants modified harmful habits such as smoking and drinking, and paid more attention to their diet in order to protect their health. However, they were less proactive with regard to using community health services. This was driven by a combination of factors including low awareness, accessibility issues, and attitudes such as the acceptance of their health circumstances as an inevitable result of old age. Participants were likely to be more active in taking action if encouraged by a comprehensive social support network.

Conclusions

In general, the health-seeking behaviours of stroke survivors were restricted to actions which were directly under their control, such as the cessation of harmful habits and diet modifications. Behaviours linked to seeking healthcare services were limited by poor knowledge, accessibility, and personal attitudes about health.