Authorship
Discuss about the Combined Perceptions Of People With Stroke And Their Carers Regarding Rehabilitation Needs 1 Year After Stroke: A Mixed Methods Study.
Caregivers are essential in helping people that are recovering from a stroke. Therefore, a care-provider can apply various techniques. Specifically, the practices can be utilized when supporting a female who is a 67-year-old family member (Aunt Sue?Anne). First, caregivers have to comprehend the side effects of stroke. It is vital to effectively adhere to the medical schedule outlined by a health expert. The people taking care of those recovering from a stroke should clearly understand stroke’s emotional impact, for instance, anxiety and depression. However, they have to help the patients overcome these situations.
The authors conducted an outstanding research that is helpful to the society as they are qualified health experts. The strength of the authors’ expertise is the discovery that dyadic perspective is significant in regards to the utilization of an organized approach when conducting rehabilitation. Although the authors were qualified to perform the research, the utilization of open-ended questions did not seem to provide adequate information. Consequently, the responses from people with stroke and caregivers were examined separately and comparison made between caregivers and people with stroke at a group level. The research finding could be biased due to the existence of varied ideologies and personal attributes or experiences (Opara and Jaracz, 2010). For instance, the coding of the interviews may be done at one’s own perception or understanding hence providing wrong analysis.
The major purpose of the study was to examine the relationships which exist between dyad’s (people with stroke and their informal caregivers) perception of the people with rehabilitation needs of stroke and its severity, individual factors (sense of coherence, age and gender), utilization of rehabilitation services, caregiver burden and amount of crucial informal care. Therefore, authors considered their research to be imperative. Subsequently, this is because their study aimed at exploring the individual experiences of daily life transformations among people with stroke (Ekstam et al, 2015). Furthermore, the research analyzed caregivers and the techniques they use when handling the stroke patients after 1 year.
In accordance with the article, the research design is relevant hence suitable. The authors have explicitly justified the various methods utilized during the research. A diversified methods design was applied combining qualitative and quantitative data and consequent analysis. Data collection was done through various conventional techniques and open-ended interviews (Ekstam et al, 2015). The perception of the dyads in regards to rehabilitation needs of the people with stroke and the informal caregivers was done through questionnaires.
Research Questions
Attained results were categorized into three classifications. These were unmet, met and discordant rehabilitation needs. SOC, sense of coherence, was assessed using SOC-scale whereas caregiver burden was evaluated caregiver burden scale (Jakobsson, 2011). Data concerning utilization of rehabilitation services was acquired from a computerized register of the Stockholm County Council.
The research utilized a diversified methods design which combined qualitative and quantitative data and subsequent analysis. Structured and semi-structured interviews were used to conduct baseline evaluation during the first week of stroke. The structured interviews were in form of questionnaires while the semi-structured interviews were open-ended questions. Crucial data from informal caregivers were collected using similar techniques (Ekstam et al, 2015). Participants in the study were required to answer a question in regards to the satisfaction of rehabilitation necessities mostly after one year of follow-up.
Medical records and interviews were utilized in collecting data from people affected by stroke. Specifically, the data was on stroke severity, age, and sex. In the same token, open-ended questions were significant in data collection more so one year after stroke concerning transformations in managing and handling daily activities. Participants conveyed answers orally as research assistants noted them down.
Data from informal caregivers on their relationships with persons with stroke, age and sex were obtained by the use of interviews. Questionnaires were then applied to determine the caregiver’s opinion in regards to satisfaction and the necessity of healthcare services. Care-provider Burden Scale was essential more so after 12 months in assessing caregiver burden (Ekstam et al, 2015). Inquiry using interviews was made from caregivers to determine if there was any assistance sought by stroke patients concerning help in conducting daily activities.
The researchers of the study extensively used interviews in data collection. Interviews are beneficial because they enable the asking of more detailed questions. It is easy to seek comprehensive information concerning personal perceptions, feelings, and opinions. Ambiguities are clarified and inadequate responses followed up (King and Horrocks, 2010). Interviewee’s answers are not influenced by other factors. Consequently, facial expressions and body language used to reinforce explanations are explicitly identified and comprehended.
On the contrary, interviews are time-consuming. Typically, interviews require much time in preparing interview questions, the actual interview, transcribing, analysis and reporting (Rowley, 2012). Therefore, these factors make interviews to be costly to perform. Different interviewees may understand the same question differently hence provide varied responses (Marshall et al, 2013). Likewise, interviews can lead to the delivery of biased responses hence wrong data. Contrariwise, it is vital to use an interview to conduct a successful research hence obtain first-hand data.
Research Design
The utilization of questionnaires in the research was necessary. They are economical both to researchers and respondents in terms of effort, cost and time. They ensure a wide coverage hence collect maximum information. It is easy to review responses hence encourages future analysis of the already collected data. Planning and administering questionnaires is easy. Respondents are at liberty to respond to the questionnaires at their own convenience (Langhorne, Bernhardt and Kwakkel, 2011). Additionally, this method ensures that there is uniformity in responses provided. Information gathered is more valid since there is the bias of the research as the recording of information in the questionnaires is done by respondents. Respondents are confident when disclosing information because questionnaires ensure anonymity.
Nonetheless, questionnaires are not explained to the targeted respondents hence are misinterpreted leading to the collection of irrelevant information. Similarly, this method of data collection is only relevant to literate people and hence it lacks personal contact. Unless questionnaires are administered in person, there could be a poor response. Questionnaires are unreliable if questions are misunderstood (Saris and Gallhofer, 2014). Consequently, questionnaires could be useless if the handwriting of respondents is illegible. Moreover, they do not create rapport with subjects. Typically, some people are not willing to convey vital information unless they are impressed by the personality of the researcher.
Data analysis was conducted to find out dyad’s collective perception of rehabilitation necessities. Results in regards to rehabilitation needs were combined and grouped into unmet, discordant and met rehabilitation needs. ANOVA test was specifically important in revealing whether there exists any difference between the outlined three classifications. Chi-square test was imperative in analyzing the difference between various groups of joint perception concerning rehabilitation necessities with regard to informal care, stroke severity and sex (Ekstam et al, 2015). Information in the form of responses from the standard open-ended questions was analyzed by use of content analysis. Information from interviews was individually coded by the authors. Summaries were then discussed by the authors.
The use of ANOVA in data analysis ensures the reduction of random variability. It also provides a robust design in data scrutiny. ANOVA evaluates the relationship that exists between various factors (Cardinal and Aitken, 2013). On the contrary, with the use of one-way ANOVA in evaluating different categories of data, it is difficult to find out the group that is different.
Subsequently, content analysis is cheap, easy to comprehend hence was appropriate for data analysis for the study conducted. Furthermore, the research was successful in using content analysis because it is a powerful tool, especially when combined with interviews (Schreier, 2012). It is straightforward and easy to determine reliability through the use of content analysis (Neuendorf, 2016). Nevertheless, content analysis is basically a descriptive method hence might not disclose the reasons for the observed patterns or results.
Research Methods
The research found out that only 86 people out 349 of those suffering from stroke had a caregiver one year after the condition. 62 out of the 86 caregivers were partners, six were children of the persons and 18 people failed to reveal the relationship explicitly. The average age of the care-providers was 65 years. The male caregivers were 17 while women were 39. Additionally, the data of 20 people in regards to their gender was not available. Amongst the dyads, 52% supposed that rehabilitation necessities were met, 13% observed that the needs were not met and 35% were categorized as discordant since they were not in agreement (Ekstam et al, 2015). 29% of the persons with stroke alleged that their rehabilitation requirements were not met whereas 71% supposed that their needs were met. Likewise, 66% (57 in number) of care-providers perceived met recovery needs for people with a stroke while 34% (29 caregivers) supposed not met needs.
Stroke severity was discovered to be associated with dyads’ rehabilitation requirements. A majority of the people with stroke revealed that their lives were same as before the situation. However, amongst the dyads’, many people with stroke stated that they had difficulties in walking and had to rely on wheelchairs. Dyads whose recovery necessities were fulfilled testified that they had minimal walking difficulties. Furthermore, they only had particular challenges like general hand weakness causing problems in conducting activities such as buttoning clothes and peeling potatoes (Ekstam et al, 2015). Contrariwise, dyads with unmet rehabilitation requirements had challenges in performing activities which are more demanding like gardening and dressing. Similarly, the people developed other conditions, for instance, dementia and pneumonia.
Statistical analysis revealed that there were no differences in the perception in regards to rehabilitation requirements in relation to rehabilitation services use, age or sex. People with met rehabilitation needs displayed a greater sense of coherence in comparison to discordant dyads. Strategies, for example, getting involved in physical activities reduce challenges associated with stroke (Hillier and Inglis?Jassiem, 2010). Caregivers perceived minimal care-providers burden in dyads in case rehabilitation necessities were met. Generally, all care-providers regardless of the group revealed that the felt homebound hence could not leave the people with stroke alone. Therefore, from the above findings, it is evident that the results of the research sufficiently fulfill the purpose of the study.
There are various factors which impact on the usage of evidence practically. Education level greatly influences the extent to which evidence is applied in actual practice. Capability to review literature affects the ability to actually implement research evidence. On the other hand, several barriers hinder the application and implementation of evidence to practice. They include inadequacy of appropriate information and time (Felicity, 2013). Moreover, improper planning also curtails applying evidence to practice.
Conclusion
The research is effective as it will aid improve the lives of the people with stroke more so one year after rehabilitation. On the contrary, caregivers ought to be encouraged or motived to conduct their duties effectively regardless of whether their care provision alters with their social lives. Nonetheless, there are advantages that arise as a result of spending time with stroke recovering patients. Profound relationships are established due to having adequate time especially if the caregivers are family members. Moreover, it is imperative in the society to adequately take care of people who are recovering from diverse medical conditions.
References
Cardinal, R. N., & Aitken, M. R. (2013). ANOVA for the behavioral sciences researcher. Psychology Press.
Ekstam, L., Johansson, U., Guidetti, S., Eriksson, G., & Ytterberg, C. (2015). The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study. BMJ open, 5(2), e006784.
Felicity Bright, B. S. L. T. (2013). Barriers and facilitators to engagement in rehabilitation for people with stroke: a review of the literature. New Zealand Journal of Physiotherapy, 41(3), 112.
Hillier, S., & Inglis?Jassiem, G. (2010). Rehabilitation for community?dwelling people with stroke: home or centre based? A systematic review. International Journal of Stroke, 5(3), 178-186.
Jakobsson, U. (2011). Testing construct validity of the 13-item sense of coherence scale in a sample of older people. The Open Geriatric Medicine Journal, 4(1), 6-13.
King, N., & Horrocks, C. (2010). Interviews in qualitative research. Sage.
Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011). Stroke rehabilitation. The Lancet, 377(9778), 1693-1702.
Marshall, B., Cardon, P., Poddar, A., & Fontenot, R. (2013). Does sample size matter in qualitative research?: A review of qualitative interviews in IS research. Journal of Computer Information Systems, 54(1), 11-22.
Neuendorf, K. A. (2016). The content analysis guidebook. Sage.
Opara, J. A., & Jaracz, K. (2010). Quality of life of post–stroke patients and their caregivers. Journal of medicine and life, 3(3), 216.
Rowley, J. (2012). Conducting research interviews. Management Research Review, 35(3/4), 260-271.
Saris, W. E., & Gallhofer, I. N. (2014). Design, evaluation, and analysis of questionnaires for survey research. John Wiley & Sons.
Schreier, M. (2012). Qualitative content analysis in practice. Sage Publications.
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