The relationship between social support and participation in stroke: A systematic review

Background: The incidence of cerebrovascular accidents with its devastating effects on individuals is increasing. Post-stroke, restrictions in participation are common and social support could have an influence on this. Social support provided to individuals post-stroke is vital, but the relationship between social support and participation is not well understood. Objectives: This review aimed to systematically determine the relationship between social support and participation post-stroke, based on the literature available. Method: Ebscohost, Science Direct, Biomed Central, Cochrane Library, Google Scholar, Pedro Central and Wiley Online were the electronic databases searched between 2001 and 2016. Articles were deemed to be eligible if they met the inclusion criteria and successfully underwent scrutiny to determine their relevance and methodological quality, using tools from the Critical Appraisal Skills Programme and Milton Keynes Primary Trust. A narrative synthesis method was used to analyse the included studies. Results: A total of 54 articles were identified after screening, and six articles were deemed eligible for inclusion. The articles consisted of cross-sectional, qualitative and cohort studies. Articles showed distinct, significant relationships between social support and participation where the quality and quantity of social support were important. High levels of social support had a positive influence on participation, social and leisure activities, as well as returning to work post-stroke. Conclusion: A positive relationship exists between social support and participation post-stroke. Health professionals need to include social support interventions when attempting to manage the individual with stroke holistically, as this will have positive effects on participation

Family functioning and stroke: Family members’ perspectives

Stroke survivors often experience permanent or temporal physical and psychological stroke impairments. As a result, stroke survivors are often discharged to recover in their home environments and are cared for mostly by family members. Additionally, caregiving roles are often assumed without any formal training or preparation whatsoever. This can transform the family’s functional patterns due to adjustments that are made to accommodate the caregiving needs.To explore the experiences and influence of stroke on families and on family functioning

Reflections of academic and professional leaders on leadership in a higher education institution

Higher education institutions are under pressure to address the challenge of the leadership pipeline. Therefore, the need exists to explore the potential of current leaders and their views of leadership in higher education. Research purpose: The study aimed to explore the views of how academic and professional support leaders have shifted their thinking of and approach to leadership following their participation in a leadership development programme. Motivation for the study: Understanding the views of potential leaders about leadership and how leadership development programmes can influence their thinking is essential. Research approach/design and method: Qualitative data was gathered by means of a document analysis using reflections submitted by 19 participants of a leadership development programme. Main Findings: The results showed that the programme had an impact on how participants started reflecting on leadership styles beyond the usual description of leadership styles. Additionally, participants used the opportunity for introspection of their own role as a leader and how they need to adapt

Stroke patients’ outcomes and satisfaction with care at discharge from four referral hospitals in Malawi: A cross-sectional descriptive study in limited resource

BACKGROUND Stroke is the fourth leading cause of mortality and disability in Malawi. There is paucity of studies reporting on acute stroke functional outcomes, quality of life and satisfaction with care among patients with stroke. This study aimed to determine stroke outcomes and satisfaction with care in the country’s central hospitals. METHODS A descriptive cross-sectional study, recruiting 114 adult patients with stroke and their caregivers, was done. FIM, EQ-5D-5L, SASC and C-SASC were used to collect data. Univariate associations were assessed using the Kruskal-Wallis Test for categorical variables and the Wilcoxon Rank Sum Test for continuous variables. RESULTS With 79% of the original study sample taking part, there was improvement in patients’ functional status at discharge compared to on admission with notable improvement in self-care (p<0.001), sphincter control (p<0.001), locomotion (p<0.001), and social cognition (p<0.001), but no significant improvement in transfers (p=1.000), and communication (p=0.865). Satisfaction with care was high, with no significant differences between males and females (p=0.415), age in years (p=0.397), and distance to the clinic (p=0.615). Satisfaction ratings were also high from caregivers’ responses and their scores were not associated with age (p=0.663) or distance to the hospital (p=0.872). Quality of life was poor, most patients were either unable or had severe limitation in functional dimensions of mobility (22(28%), self-care (19(25%) and performance of usual activities (25(33%). Every additional year in age was associated with average of 0.36 decrease in quality of life score coefficient, -0.36 (95% CI: -0.63; -0.10); p=0.008. CONCLUSION Patients with stroke experience improvement in functional outcomes on discharge compared to on admission. Patients and caregivers were satisfied with care provision despite having poor quality of life post stroke treatment. There is need to focus proven interventions on areas of stroke care that can impact patients’ quality of life in resource limited settings

Academics’ knowledge and experiences of interprofessional education and practice

BACKGROUND. Interprofessional education (IPE) can be seen as the vehicle to address the health and social problems of society through collaborative approaches. Since IPE should be facilitated by educators who are skilled in this area, faculty development initiatives should be based on the principles of IPE and collaborative practice (IPECP). OBJECTIVE. To explore academics’ knowledge and experiences of IPECP. METHODS. The study used an exploratory descriptive design and the appreciative inquiry framework underpinned data gathering and analysis. The data were collected using workshops, and the participants of the workshops shared their knowledge and experiences of IPECP, which were audio-recorded and analysed using thematic analysis. Ethical clearance was obtained from the University of the Western Cape, Cape Town, South Africa. RESULTS. The analysis revealed three themes: knowledge of IPE; experiences of IPECP; and enablers of IPECP aligned to the dream and discovery phases of appreciative inquiry. The findings revealed that academics were knowledgeable about the concept of IPE and that their experiences with IPECP ranged from clinical supervision to research. Regarding enablers of IPECP, they provided important input, which could facilitate IPECP in a university faculty. These included competencies for IPECP, professional development and a common practice framework. CONCLUSION. The academics who attended the faculty development workshops were knowledgeable about the concepts of IPECP. They concluded that for IPE to be effective, a common practice framework should be adopted in the faculty to inform specific teaching and learning strategies and outcomes.DHE

Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: A systematic literature review

Background: MRI is considered to be the diagnostic tool of choice in diagnosing nerve root compromise among patients presenting with clinical suspicion of lumbo-sacral radiculopathy. There exists controversy among researchers and clinicians regarding the diagnostic utility and accuracy of MRI in detecting nerve root compromise and radiculopathy. This review evaluated 4 primary diagnostic accuracy studies that specifically assessed the accuracy of MRI in detecting nerve root compromise, as established in the current literature. Methods: Eight electronic data bases were searched for relevant articles from inception until January 2014. All primary diagnostic studies which investigated the accuracy of MRI in diagnosing nerve root compromise among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the 'Quality Assessment of Diagnostic tests Accuracy Studies' criteria. Results: Four studies qualified for inclusion in this review. The sensitivity of MRI in detecting lumbar nerve root compromise was very low at 0.25 (95 % CI) while the specificity was relatively high at 0.92 (95 % CI). Conclusions: There is lack of sufficient high quality scientific evidence in support or against the use of MRI in diagnosing nerve root compression and radiculopathy. Therefore, clinicians should always correlate the findings of MRI with the patients' medical history and clinical presentation in clinical decision making.IS

The use of a direct manufacturing prosthetic socket system in a rural community in South Africa: a pilot study and lessons for future research

BACKGROUND: Challenges exist with the provision of appropriate mobility assistive devices in rural areas. The use of the direct manufacturing prosthetic socket system is a possible solution to these challenges. OBJECTIVES: The objective of this study was to test and explore the clients’ perspectives with the application of this device. Study design: Within a mixed-methods approach, a longitudinal sequential explanatory design was applied. METHODS: The Orthotic and Prosthetic User’s Survey was administered to explore the use of the direct manufacturing prosthetic socket system in terms of function, health-related quality of life and client satisfaction. A conveniently selected sample of 21 individuals who suffered a unilateral trans-tibial amputation was included. Data were collected at 1, 3 and 6 months post fitting, and two focus group discussions were also administered. RESULTS: Of the 21 participants recruited, 11 returned for follow up. Although participants reported favourably about the prosthesis, their scores were generally worse than the norms with regard to function and quality of life. Participants highlighted the need for improvement in the cosmetic appearance of the prosthesis. CONCLUSION: The direct manufacturing prosthetic socket system could be considered as an alternative technique of socket manufacturing for individuals living in rural areas due to the shorter manufacture time and promising initial results, but further research on this topic with a bigger sample is recommended.ISI & Scopu

Assessing Clinical Placements in a B.Sc. Physiotherapy Program

Background: The clinical setting is one of the most valuable educational resources available to institutions training physiotherapy students. The experiences gained at the clinical settings assist graduates to grasp what the discipline of physiotherapy is all about. Objective: To evaluate existing clinical venues providing placement for physiotherapy students at the University of the Western Cape. Methodology: Both quantitative and qualitative methods were employed to gather data. A validated questionnaire was used to gather the quantitative information. The questionnaire consisted of a seventeen-item instrument using a Likert scale which ranged from strongly agree to strongly disagree. Five open ended questions were added to gather qualitative data which would enrich the quantitative responses. The quantitative data was analysed using SPSS and reported using descriptive statistics. The qualitative data were transcribed verbatim by an independent person and emerging themes were identified. Results: The study yielded a response rate of 61%. The majority of the respondents agreed or strongly agreed with the statements relating to satisfaction with clinical placements. The highest negative responses related to the clinicians attitudes and willingness to assist students. Conclusion: Physiotherapy students were found to be satisfied with their clinical rotations but highlighted areas that could be improved to enhance the learning that takes place at the clinical settings