Life satisfaction and self-efficacy in patients affected by a first stroke living in Kuwait: A two-phase study

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa Healthcare USA, Inc.Life satisfaction and self-efficacy are important aspects of stroke rehabilitation. Previous research focuses on Western stroke survivors, neglecting the stroke experience in the Middle East. This research was conducted in Kuwait and entailed both quantitative and qualitative phases to obtain a more comprehensive, clinically relevant understanding of self-efficacy and life satisfaction during stroke rehabilitation in this culture. The aims were to: 1) investigate the relationships between self-efficacy and life satisfaction in female patients affected by stroke (Phase 1); and 2) explore health professionals' views regarding the importance of self-efficacy and possible strategies for enhancing self-efficacy during rehabilitation, through semi-structured interviews (Phase 2). Significant correlations were found between patients' general self-efficacy, and psychosocial adaptation self-efficacy following stroke. Self-efficacy (both general and psychosocial adaptation) showed significant correlations with life satisfaction post-stroke. Health professionals (more than half of whom were physiotherapists) recognised the importance of self-efficacy within stroke rehabilitation and identified five main ways to increase self-efficacy during stroke rehabilitation. These were to: 1) motivate and encourage patients; 2) provide more education about stroke and rehabilitation; 3) identify change; 4) offer a high-quality environment and therapy; and 5) set goals. In conclusion, psychosocial self-efficacy was identified as having a stronger relationship to life satisfaction compared with general self-efficacy within this sample of Kuwaiti female patients. Health professionals suggested various strategies for enhancing self-efficacy and thereby life satisfaction post-stroke during the rehabilitation process in Kuwait. Despite the collectivist culture of Kuwait, the findings indicate that the patient's own confidence and sense of responsibility for progress may be relevant to rehabilitation

Assistive devices, hip precautions, environmental modifications and training to prevent dislocation and improve function after hip arthroplasty

This is the protocol for a review and there is no abstract. The objectives are as follows: The aim of this review is to assess the effects of provision of assistive devices, education on hip precautions, environmental modifications and training in ADL and EADL for people undergoing hip arthroplasty

Promotion of healthy nutrition in clinical practice: a cross-sectional survey of practices and barriers among physiotherapists in southeast Nigeria

AbstractBackgroundHealthy diet counselling is an important concept in health promotion. Physiotherapists are well positioned to initiate or support healthy nutrition in addition to physical activity counselling, in routine patient consultation.ObjectiveTo determine the practices about and barriers to diet counselling practices among physiotherapists in Southeast Nigeria.MethodsIn this cross-sectional survey, a total of 140 questionnaires were distributed among physiotherapists.ResultsOverall, 103 physiotherapists responded. Physiotherapists are confident and consider the incorporation of dietary counselling very important and of high priority in their daily clinical work. They, however, assessed and counselled on dietary status opportunistically in patients. Notwithstanding, physiotherapists believed that the diet counselling they give could be effective in helping patients change their unhealthy dieting practices. Patients were also amenable to physiotherapists advocating on diet issues as part of their consultation. Several barriers to incorporating diet counselling into physiotherapy practice were identified, including lack of access to a dietician/health promotion staff/counsellors, lack of proper patient education materials, lack of expertise in relation to dietary risk factors' assessment and management, and uncertainty about what dietary services to provide.ConclusionAlthough physiotherapists consider it important to incorporate diet counselling in their daily clinical practice, development and implementation of strategies to improve physiotherapists' diet counselling knowledge, competence, skills, and practice are warranted

Association between patient outcomes and key performance indicators of stroke care quality: A systematic review and meta-analysis

Purpose: Translating research evidence into clinical practice often uses key performance indicators to monitor quality of care. We conducted a systematic review to identify the stroke key performance indicators used in large registries, and to estimate their association with patient outcomes. Method: We sought publications of recent (January 2000–May 2017) national or regional stroke registers reporting the association of key performance indicators with patient outcome (adjusting for age and stroke severity). We searched Ovid Medline, EMBASE and PubMed and screened references from bibliographies. We used an inverse variance random effects meta-analysis to estimate associations (odds ratio; 95% confidence interval) with death or poor outcome (death or disability) at the end of follow-up. Findings: We identified 30 eligible studies (324,409 patients). The commonest key performance indicators were swallowing/nutritional assessment, stroke unit admission, antiplatelet use for ischaemic stroke, brain imaging and anticoagulant use for ischaemic stroke with atrial fibrillation, lipid management, deep vein thrombosis prophylaxis and early physiotherapy/mobilisation. Lower case fatality was associated with stroke unit admission (odds ratio 0.79; 0.72–0.87), swallow/nutritional assessment (odds ratio 0.78; 0.66–0.92) and antiplatelet use for ischaemic stroke (odds ratio 0.61; 0.50–0.74) or anticoagulant use for ischaemic stroke with atrial fibrillation (odds ratio 0.51; 0.43–0.64), lipid management (odds ratio 0.52; 0.38–0.71) and early physiotherapy or mobilisation (odds ratio 0.78; 0.67–0.91). Reduced poor outcome was associated with adherence to swallowing/nutritional assessment (odds ratio 0.58; 0.43–0.78) and stroke unit admission (odds ratio 0.83; 0.77–0.89). Adherence with several key performance indicators appeared to have an additive benefit. Discussion: Adherence with common key performance indicators was consistently associated with a lower risk of death or disability after stroke. Conclusion: Policy makers and health care professionals should implement and monitor those key performance indicators supported by good evidence

Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach

Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally

Initial experiences of interprofessional problem-based learning: A comparison of male and female students' viewsparison of male and female studentsâ views

Few studies have considered the contribution of PBL to interprofessional education, and even fewer have examined whether women and men evaluate PBL differently. This paper examines first year occupational therapy and physiotherapy students’ evaluations of their initial participation in interprofessional PBL, during a module focusing on communication skills and patient-focused approaches to care. Questionnaire data included attitude ratings and qualitative evaluations of PBL. 133 females and 24 males responded (comprising 83% of the total cohort). Most students were positive that PBL contributed to both personal learning and team-working skills. Both female and male students felt able to express their opinions within the seminar groups and were positive that their understanding of therapists’ roles within the multi-disciplinary team had increased. However, women expressed rather more trust in the information provided by other students, confirmed greater enjoyment in taking responsibility for their own learning and had more positive views about working with students from another course. In their qualitative comments, more women made reference to enjoying the social aspects of PBL (such as groupwork, support and collaboration). The gender differences were not substantial but those that were observed support previous researchers’ arguments that women are more inclined to be ‘connected learners’ who value the social aspects of learning contexts. The findings overall suggested that PBL made a positive, well received contribution to learning during an interprofessional module