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Development and evaluation of a nurse-led, tailored stroke self-management intervention
Conclusions: To our knowledge, this is the first UK study to explore the use of patient activation as a theoretical underpinning in stroke self-management research and to involve stroke survivors and stroke nurses in the design and development of a tailored, person-centred stroke self-management support intervention. The study findings provide the first step in understanding how to effectively develop and deliver stroke self-management support interventions to stroke survivors living at home in the first year following stroke. Further work is needed to develop and refine the intervention and identify how to effectively emb...
Source: BMC Health Services Research - September 4, 2015 Category: Journals (General) Authors: Lisa KiddMaggie LawrenceJo BoothAnne RowatSian Russell Source Type: research

Randomized clinical trial of the timing it right stroke family support program: research protocol
The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being. Methods: Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telepho...
Source: BMC Health Services Research - January 17, 2014 Category: Journals (General) Authors: Jill CameronGary NaglieMonique GignacMark BayleyGrace WarnerTheresa GreenAnna CzerwonkaMaria HuijbregtsFrank SilverSteve PhillipsAngela Cheung Source Type: research

A comparison between reported therapy staffing levels and the department of health therapy staffing guidelines for stroke rehabilitation: a national survey
Conclusions: Most in-patient stroke units are operating below the DoH guidelines and are therefore challenged in providing the recommended amount of therapy and patient time to facilitate optimal functional recovery for stroke patients.
Source: BMC Health Services Research - May 14, 2014 Category: Journals (General) Authors: Gabrielle McHughIan Swain Source Type: research

Training emergency services' dispatchers to recognise stroke: an interrupted time-series analysis
Conclusions: This is the first study to develop, implement and evaluate the impact of a training package for EMDs with the aim of improving the recognition of stroke. Training led to a significant increase in the proportion of stroke patients dispatched as such by EMDs; a small reduction in time from call to arrival at scene by the ambulance also appeared likely. The training package has been endorsed by the UK Stroke Forum Education and Training, and is free to access on-line.
Source: BMC Health Services Research - August 15, 2013 Category: Journals (General) Authors: Caroline WatkinsMichael LeathleyStephanie JonesGary FordTom QuinnChris Sutton Source Type: research

Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions
Conclusions: Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors.
Source: BMC Health Services Research - March 10, 2014 Category: Journals (General) Authors: Nor Mohd NordinNoor AzizAznida Abdul AzizDevinder Ajit SinghNor Omar OthmanSaperi SulongSyed Aljunid Source Type: research

The use of Cincinnati prehospital stroke scale during telephone dispatch interview increases the accuracy in identifying stroke and transient ischemic attack symptoms
Conclusions: Centres that use CPSS more frequently during phone dispatch showed greater agreement with on-the-scene prehospital assessments, both in correctly identifying more cases with stroke/TIA symptoms and in giving fewer false positives for non-stroke/TIA cases. Our study shows an extreme variability in the performance among OCs, highlighting that form many centres there is room for improvement in both sensitivity and positive predictive value of the dispatch. Our results should be used for benchmarking proposals in the effort to identify best practices across the country.
Source: BMC Health Services Research - December 11, 2013 Category: Journals (General) Authors: Assunta De LucaPaolo RossiGuido Villa Source Type: research

Health state descriptions to elicit stroke values: do they reflect patient experience of stroke?
Conclusions: Variation exists in the content of health state descriptions for all levels of stroke severity, most critically with a major disjuncture between the content of descriptions and how stroke is experienced by patients. There is no systematic method for constructing the content/scope of health state descriptions for stroke, and the patient perspective is not incorporated, producing descriptions with major deficits in reflecting the lived experience of stroke, and raising serious questions about the values derived from such descriptions and conclusions based on these values.
Source: BMC Health Services Research - November 21, 2014 Category: Journals (General) Authors: Joanne GrayMabel LieMadeleine MurtaghGary FordPeter McMeekinRichard Thomson Source Type: research

Provision of inpatient rehabilitation and challenges experienced with participation post discharge: quantitative and qualitative inquiry of African stroke patients
Conclusion: Stroke patients admitted to hospitals in certain African countries could receive limited in-patient therapeutic interventions. With the exception of barriers in the physical environment, stroke patients in developing countries where resources are limited experience the same participation restrictions as their counterparts in developed countries where resources are more freely available. Rehabilitation interventions in these developing countries should therefore be community-based focussing on intervening in the physical environment.
Source: BMC Health Services Research - September 28, 2015 Category: Journals (General) Authors: Anthea RhodaNatalie CunninghamSimon AzariaGerard Urimubenshi Source Type: research

Peer support for stroke survivors: a case study
Conclusions: Peer support can potentially enhance service to stroke survivors and promote community reintegration for peer volunteers. Further research is needed to determine the preferred format and timing of peer support, and the characteristics of stroke survivors most likely to benefit.
Source: BMC Health Services Research - June 16, 2014 Category: Journals (General) Authors: Dorothy KesslerMary EganLucy-Ann Kubina Source Type: research

Assistive technologies after stroke: self-management or fending for yourself? a focus group study
Conclusions: Considerable systemic barriers to realising the potential of assistive technologies in upper-limb stroke rehabilitation were reported. Attention needs to be paid to increasing evidence of assistive technology effectiveness and develop clinical service provision. Device manufacturers, researchers, health professionals, service funders and people with stroke and family caregivers need to work creatively and collaboratively to develop new funding models, improve device design and increase knowledge and training in assistive technology use.
Source: BMC Health Services Research - August 22, 2013 Category: Journals (General) Authors: Sara DemainJane BurridgeCaroline Ellis-HillAnn-Marie HughesLucy YardleyLisa Tedesco-TriccasIan Swain Source Type: research

Investigating preferences for support with life after stroke: a discrete choice experiment
We report the first investigation of patients' and family carers' preferences for community services after stroke using a discrete choice experiment (DCE). Methods: Two workshops with patients and family carers (n = 8) explored stroke experiences, identifying attributes important in shaping views about service design, and piloted data collection strategies. Attributes were group versus individual support; service provider; additional support for social and leisure activities; and the total time required to access services. Patients and family carers were recruited six months post stroke-onset (mean 331 days) from four stro...
Source: BMC Health Services Research - February 8, 2014 Category: Journals (General) Authors: Christopher BurtonEmily FargherCatrin PlumptonGwerfyl RobertsHeledd OwenEryl Roberts Source Type: research

Motor and functional recovery after stroke: A comparison between rehabilitation settings in a developed versus a developing country
Conclusion: The results of this study provide empirical evidence for differential recovery patterns for patients in developed and developing countries. A detailed exploration of the factors to which this difference in recovery patterns can be attributed was beyond the scope of the present study, and is recommended for future research.
Source: BMC Health Services Research - February 22, 2014 Category: Journals (General) Authors: Anthea RhodaMario SmithKoen PutmanRatie MpofuWilly DeWeerdtLiesbet DeWit Source Type: research

Speech pathologists' experiences with stroke clinical practice guidelines and the barriers and facilitators influencing their use: a national descriptive study
Conclusions: There are many different factors that can influence speech pathologists' implementation of CPGs. The factors that influenced the implementation of CPGs can be understood in terms of knowledge creation and implementation frameworks. Speech pathologists should continue to adapt the stroke CPG to their local work environment and evaluate their use. To enhance guideline implementation, they may benefit from a combination of educational meetings and resources, outreach visits, support from senior colleagues, and audit and feedback strategies.
Source: BMC Health Services Research - March 6, 2014 Category: Journals (General) Authors: Kathleen HadelyEmma PowerRobyn O¿Halloran Source Type: research

Exploring the impact of intravenous thrombolysis on length of stay for acute ischemic stroke: a retrospective cohort study
Conclusions: IVT reduced the risk of prolonged LOS in patients with acute ischemic stroke. Measures to increase the rate of IVT are encouraged.
Source: BMC Health Services Research - September 23, 2015 Category: Journals (General) Authors: Ling-Chien HungYa-Han HuSheng-Feng Sung Source Type: research

Cost of stroke: a controlled national study evaluating societal effects on patients and their partners
Conclusion: Stroke has significant mortality, morbidity and socioeconomic consequences for patients, their partners and society.
Source: BMC Health Services Research - October 13, 2015 Category: Journals (General) Authors: Poul JennumHelle IversenRikke IbsenJakob Kjellberg Source Type: research

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