Do The Effects Of Education Support For Post-Stroke Carers Enhance Coping Strategies - Essay Example

“Do the effects of education support for post-stroke carers enhance coping strategies?” Introduction In the lives of individuals after stroke, carers are quite vital as they are endowed with the responsibility of providing physical, practical and emotional assistance to the victims befallen by such a calamity (Bogousslavsky 2002). The carers experience a lot in their efforts to try and take care of such patients given the gravity presented by stroke as a disease(Wong 2013). In the past there have even been cases of depression reported among the caregivers of the stroke survivors. The research is therefore aimed at finding out about how the caregivers are affected negatively in the process of their duty (Culebras 2000). This will go a long way in the formulation of ways to support them through relevant education and the impact of such education on their subsequent involvements will be assessed (Wiebers, Feigin& Brown 2006). The essay is structured in a way that at the end of it the users of the article will be able to rip utmost benefit from the content. First, an explanation of the process involved will be conducted. This is coupled by an explanation of the issue being examined in skeleton opening ways as to why the issue needs to be discussed(Caplan 2006). Secondly, a background about the topic will be laid down where a summary of the topic will be made and original research works highlighted. Thereafter, a methodology, discussion and conclusion about the post-stroke effects on carers are and this will entail that which can be done about the same (Sauerbeck2008). The significance of this topic emanates from the fact that carers need to be provided with information and training to enable them discharges their work well. Such resourceful support ought to take place at all the stages of the recovery process and hence the assessment of the education support availed (DeLuca 2005). Research has it that the carers are at a high risk given the nature of their work due to factors such as poor emotional outcome(Caplan 2006). This calls for not only am assessment of factors related to the patients alone but also an interview of the caregivers of their experiences and challenges during the post stroke period. Formulation of a research question The research question formulated adopts the SPICE model given it is directed towards finding out how education empowerment helps the carers of post-stroke survivors cope. This is due to the recent happenings showing us that thecarers are normally greatly affected by the work they do while taking care of such patients (Mas 2012). As the researchers we are the supervisors, then the community and the carers form the partners; in the process of conducting the research we would make choices as required and use non-biased incentives. Of course, the main objective is educating the cares and finding the impacts of such trainings (Wiebers, Feign & Brown 2006). According to the NHS Outcomes Domain three, it is clear that the carers go an extra mile in helping people recover from ill health. The specific target in this case is the post stroke survivors. The issues being investigated are of paramount significance and of even great importance to my field of practice. This is because from research we find that the carers are greatly affected by the conditions and the environment under which they operate(Sauerbeck 2008). As a result, we may say they help the post-stroke patients but at the same time they are affected socially and health wise (Emam, Drouin & Melo 2008). The most common health problems they face are psychological in nature a situation which falls under the NHS Outcomes framework. This is due to the fact that people have to be helped recover from episodes of ill health (Sunderes 2009). As a result of this study, the propositions made would greatly help in improving the lives of the carers’ of such patients. The government will be in a position of investing more in this sector in terms of finances (Deshpande 2008). Furthermore, the recommendations will equip the carers with the rightful information of how to handle the patients even as they strive to remain unaffected. The themes in all the identified articles focus on research conducted to help carers cope (Gallis 2006) Background These care givers are known to provide both physical and psychological supports to the post stroke patients (Gan & Ramani 2008). Such support are categorized as informal and as a result the carers have been reported to experience a lot of burden , this has been evidenced in the ever deteriorating health of the carers and alongside this, their social and wellbeing has as well been on the deterioration(Wiebers, Feigin& Brown 2006). This has prompted the realization that from simply looking at the caregivers as colleagues to the professional carers, we should view them as patients who as well require care given the problems and challenges that they face (Williams 2010). Their special needs should therefore be provided for accordingly and education is the first step towards realizing this. This will ensure that the carers are able to handle patients in a manner that they get relieved from their conditions (Harrison 2005). As advanced by the journal of advanced nursing, we are able to view the lives of the families affected by stroke. Such families are those representing the families of the victims as well as the families of the caregivers and in each case we are able to witness unique effects to each of the families (Harrison 2005). The Journal of the clinical nursing on the other hand is able to give us a narrowed down view of this effect on the lives of the carers and the journal makes an analysis by linking this to the post-stroke survivors. A research paper by the informa healthcare gives us a qualitative analysis of the experiences of the carers of the life after stroke (Mohr 2004). Under this article, the experiences of the carers as they care for the stroke survivors was sought, alongside this was their reactions and changes in their lives using phenomenological approach.. The international journal for nursing practice as well provides us with a research paper on managing the carer of stroke survivors. Under, the article, we are able to see ways of ensuring that the lives of the carers are not a hell. The Clinical Rehabilitation on the other hand gives us the contrasting view of the lives of the carers and that of the patients alike (Moore 2009).As observed, there is dire need to support the carers of the post-stroke survivors given the observation that they face a lot of burden as they strive to give the survivors utmost physical and psychological support. Most of these cares were found to be ignorant of so many things, that they ought to use or apply to aid their support to such people and as well ensure they are not affected much(Williams 2010). These people are part of the community we live in and any substantial impact on their lives in one way or the other results into another substantial impact on us. This prompts the need to empower them through education; this will make them enlightened and as well make them understand everything around and about them in course of their duties (Nolan 2007). Methodology This section focuses mostly on the secondary data methodology. As witnessed earlier the SPICE framework was adopted since this is a medical problem and it as well affects the community units. We have the patients on one hand and the carers on the other hand (Patterson 2008). Given this mix, several families are affected in one way or the other here; the most affected and traumatized are the families of the patients and the carers. To arrive at the information, we were forced to use both the primary and the secondary methods of obtaining information. The primary methods used entailed both observation and personal interview. We stratified the region into 8 geographical units after which we sampled 60 victims from each region. With the designed questionnaires we could visit each of the victims of post-stroke condition and arrange to question the carers as the condition of the patients in them was unbearable. The findings from these would later be analysed and used together with the secondary sources to come up with solid recommendations to aid the coping of the carers of the post-stroke survivors (Sherman 2007). The main source of my information was the secondary sources; here I consulted a variety of clinical journals and research papers. For instance, the journal of Advanced Nursing was able to provide me with the information that would help me understand the lives of the families affected by stroke. It is the work of the informal carers to take care of the post stroke survivors in the community as a result in one way or the other the carers can get affected in terms of health and well-being (Stroke patient education tool kit. 2007). Some cases have even been reported of cases where the families of the carers are affected due to maybe the unavailability of the family members. From a research paper by Cathy Bulley we were able to get the experiences of the carers through a phenomenal approach where data was collected and analysed. Semi structured interviews were as well conducted and the findings recorded on the articles with the findings indicating that lives were turned upside down as it took the participants long to understand the impacts of the stroke (Winnick 2006). Using Critical Appraisal Skills Programme (CASP), I was in the position of critically evaluating the journals collected and the primary data analysed to find the gap that existed and make recommendations.Through the analysis of the Journal of critical nursing for example, a small scale qualitative study of experienced carers was undertaken of which 10 carers were sampled through the assistance of the community stroke staff(Redman 2007). Here, carers were analysed in terms of what they want to do, that which they expect to do for the patients they care for. Therefore it was fund out that the education curriculum for the carers should be developed with factors that are able to protect them against stress. In addition, it was recommended that measures be put in place to eliminate the factors that are detrimental to their operations (The NHS performance assessment framework /NHS Executive, 1999). Another research paper managing as carers of stroke survivors talks about an interview that was conducted on the carers to help determine their perspectives on the support they require as well as the educational needs they require to be able to discharge their roles effectively and at the same time be in the position of coping with the situations they face on their daily operations (Winnick 2006). According to this paper, it is clear that the carers in the first place experience the burden since they are not even certain about what their roles are. They are not as well certain about their future but the good news is that through the education and empowerment provided they are able to employ a variety of coping strategies to manage their caring roles (Redman 2007). According to the NHS Outcomes Frameworks of 2013/14 the articles met by all standards with regards to health and care systems as established on the measuring outcomes. There are varied experiences of the participants that in one way or the other have been affected. The manners in which the carers and the survivors are affected also vary in a great deal. These are according to the 30 samples that were taken and the timing they were given. The carers play and increasing role in the welfare of the patients and the patients they focus on have variety of ailments and disabilities. These are as reflected in the UK strategy documents, the documents themselves point to the needs of the carers, so that they are empowered to engage in care planning and to be kept fully informed of all the available services. It was furthermore recommended that they have to receive appropriate training on the appropriate caring roles (Montoya & Fleisch 2012). As mentioned earlier, both observation and personal interviews were employed as a way of getting information from then primary source. The eight regions each produced a sample of 60 participants as shown in the table below. region Sample participants Mean acceptance(positive) S.D 1 60 25.63 2.213 2 60 52.45 2.56 3 60 56.2 4.21 4 60 58 6.32 5 60 61.23 5.6 6 60 25 4.12 7 60 12.3 3.6 8 60 57.36 2.36 The regression analysis that produced the above data does not tend to show much consistency. According to the mean data produced on average the information analysed are fairly above average. This confirms the need for educating the carers to enhance their capacity in terms of giving quality assistance to the post-stroke survivors. At the same time, the education established provided that all the interested parties are satisfied at the end of the day. This means the families of the parties and the community at large is not negatively affected. (See data extraction table in the appendix) According to the findings from the analysis and the secondary data for the research papers and the journal, there are a variety of findings: -the health situations of the post stroke survivors are not always similar at any point, they are varied (Walkins 2011). This indicates that the levels of care they need will as well vary significantly. The impacts of the strokes are also not the same depending on the factors that resulted on the influences. It is also found out that the operations and activities that surround the post-stroke care affects the whole community given the carers are members of the same communities (Mead 2013). There is therefore the need for the carers to be taken care of through the provision of basic education to enable them handle the patients. Discussion Mainly stroke has been attributed to lifestyles making it be one of the most lethal lifestyle diseases. This makes the disease a preventable one just as they are caused by a variety of factors. One of the factors is the age with the most prevalent cases being those above the age of 65 years. A rare case is that which results from family history, if a family has a history with some of the individuals having suffered the disease (Warlow 2008). This disease is also found to be ethnic in nature with people from south Asia, Africa and Caribbean prone to acquiring the disease. Among the other causes, it was as well found out that one’s medical history is another very prudent cause of the disease(Wong 2013). Depending on the cause of this disease on an individual, the education curriculum will be in the position of providing a platform over which the disease can be prevented so that its impacts are greatly minimised. Knowing the causes and how varied they are creates a situation where we are able to institute ways of handling the problem in manner that the diseases are preventable. In addition, we are able to enhance the quality of life of the people whose conditions with regards to the same are prolonged. Depending on the level of care for each patient, the carers will as well be educated and as a result they will know of the creative ways of ensuring they handle them depending on their criticality. The most critical situations are given more consideration and urgency. This makes it possible for the carers to help the survivors recover from their encounters that resulted from the shock (Mead 2013). The other point is that the impacts of stroke are as well not always with the same magnitude. The carers must therefore be aware of this; they deserve to be equipped with the relevant knowledge so that they are able to know the magnitude of each case (Wong 2013). The education has as well proved that the carers can be equipped with the relevant knowledge on how to handle such cases differently (Caplan 2006). In the process of taking care of the patients they can in the process find it easier to know the causes and advise the patients in case they are able to see them digressing on their roles. The community is an important component of the society and the affairs of the community must be guarded. This will ensure that there is prosperity that is registered at all the levels of the community (Lindley 2008). Care after educating the carers will make it possible for the people to be in apposition of realising positivism in terms of care and experience. Conclusion Effects of education support to post stroke carers on their coping are therefore very important. This is because for one, the education helps relieve the carers of the burdens that they are faced with in their daily practice. It is also important for victims across the board to be aware of all the causes and effects of the stigma that is prone to a majority of the members of the society. Ways of doing away with such stigma must therefore be put in place at the right time for the benefits of all the members of the society (Fisher 2009). With all the strategies as summarised above being taken care of, a continuity of the whole community will always be ensured. References Bogousslavsky, J, 2002, Long-term effects of stroke, M. Dekker: New York. Caplan, LR, 2006, Stroke, Demos: New York. Culebras, A, 2000, Sleep disorders and neurological disease, M. Dekker: New York. DeLuca, J, 2005, Fatigue as a window to the brain, MIT Press: Cambridge, Mass. Deshpande, A, 2008, Telehealth for acute stroke management (Telestroke) systematic review of analytical studies and environmental scan of relevant initiatives. Ottawa, Ont.: Canadian Agency for Drugs and Technologies in Health = Agence Canadienne des MeÌdicaments et des Technologies de la Santé. Emam, K, Drouin, J, & Melo, W, 2008, SPICE: the theory and practice of software process improvement and capability determination, IEEE Computer Society Press: Los Alamitos, Calif. Fisher, M, 2009, Stroke, Elsevier: Edinburgh. Gallis, MA, 2006, Accelerating DSMC data extraction, United States. Dept. of Energy: Washington, D.C. Gan, RN, & Ramani, NV, 2008, The stroke clinicians handbook a practical guide to the care of stroke patients, World Scientific: New Jersey. Harrison, MA, 2005, Physiotherapy in stroke management, Churchill Livingstone: Edinburgh. Lindley, RI, 2008, Oxford University Press: Stroke, Oxford. Mas, A, 2012, Software process improvement and capability determination 12th International Conference, SPICE 2012, Palma, Spain, May 29-31, 2012. Proceedings, Springer: Berlin. Mead, G, 2013, Exercise and fitness training after stroke: a handbook for evidence-based practice. Elsevier: Edinburgh. Mohr, JP, 2004, Stroke: path physiology, diagnosis, and management (4th ed.), Churchill Livingstone: New York. Moore, D, 2009, The role of the Registered [Surgical] Nurse in the 21st century NHS acute trust hospital an ethnographic study, Kluwer Law International: Cambridge. Montoya, M, & Fleisch, E, 2012, Affordable, Portable, and User-Centered Systems for Stroke Subjects upper Extremity Rehabilitation Devices for Home Use, Springs Valley: Carlifornia. Nolan, M, 2007, Partnerships in family care, Open University Press: Maidenhead. Patterson, IL, 2008, A process improvement guide for ISO 9001 using the SPICE framework, DalTech: Halifax, N.S. Redman, BK, 2007, The practice of patient education: a case study approach (10th ed.), Mosby: St. Louis, Mo. Sauerbeck, LR, 2008, Smoking cessation after stroke: education and its effect on behaviour, Oxford University: Oxford. Sherman, D, 2007, Advances in stroke management, Lippincott-Raven Healthcare: Cedar Knolls, N.J. Stroke patient education tool kit, 2007, Dallas, Tex.: American Stroke Association. Sunderes, R, 2009, Quality and performance in the NHS: clinical indicators, Dept. of Health: London. The NHS performance assessment framework /NHS Executive, 1999, Dept. of Health: London. Walkins, J, 2011, Stroke management, Cambridge University Press: Cambridge, MA. Warlow, C, 2008, Stroke: practical management (3rd ed.), Blackwell Pub: Malden, Mass. Wiebers, DO, Feigin, V., & Brown, RD, 2006, Handbook of stroke (2nd ed.) Lippincott Williams & Wilkins: Philadelphia. Williams, J, 2010, Acute stroke nursing. Chichester, Wiley-Blackwell: West Sussex. Winnick, JP, 2006, Adapted physical education and sport (4th ed.), Human Kinetics: Champaign, IL. Wong, CW, 2013, "Natural" care: the lived experience of European and Chinese family carers for their stroke impaired relatives in Auckland, New Zealand: a qualitative study. Kingston: Kingston. APPENDIX Timmins & McCabe data extraction summary table Author and year Journal Type of study Purpose Sample Design Data collection Key findings Cecil, R; Thomson, K; Parahoo, K and McCaughan, E. 2012 Journal of Advanced Nursing (JAN) Qualitative study To explore the lives of carers of stroke survivors in terms of caring and coping and identify the factors that had an impact on their lives Thirty participants. All carers were white and identify themselves as British or Irish. 23 women and 7 men. 19 were spousal carers (15 wives and 4 husbands).7 adult children (4 daughters and3 sons). 3 sisters and a woman who was caring for her husband`s father`s cousin. Qualitative descriptive study. Interviews conducted at the carers’ home. In some cases the stroke survivors were present at the interview and contribute to discussion. Nine themes emerged which were divided into three broad categories: 1. The impact of the stroke: Extrinsic factors that support the caring scenario Intrinsic factors that help a carer cope. 2. Changes to lifestyle Health professionals Own health and well-being 3. Concerns and worries Information and knowledge Gratitude and faith 4. Mental health issues Family support The dyadic relationship. Cobley, S C; Fisher, J R; Chouliara, N; Kerr, M and Walker, F M. 2012 Clinical Rehabilitation Qualitative study To investigate patients` and carers` experience of early supported discharge services and inform future early supported discharge service development and provision. 27 stroke patients and 15 carers. The carers were all spouses and female. Semi-structured interview framework. Interviews were conducted in the patients` usual place of residence. Semi-structured interview. Themes: 1. The home-based form of rehabilitation 2. Speed of response 3. Intensity and duration of therapy 4. Respite time for the carer 5. Rehabilitation exercises and provision of technical equipment 6. Limited support in dealing with carer strain 7. Lack of education and training for carers 8. Inadequate provision and delivery of stroke-related information. Cecil, R; Parahoo, K; Thompson, K; McCaughan, E; Power, M and Campbell, Y. 2010 Journal of Clinical Nursing (JCN) Qualitative study To explore the personal experiences of carers of stroke survivors and to elicit their views and opinions of what constitute the major issues and concerns of people in their situation. 10 carers were recruited. All participants were women whose husbands had suffered a stroke. A small- scale qualitative study of experienced carers of stroke survivors. In-depth semi-structured interviews and the focus group. Semi-structured interviews were conducted with four carers (2 individual interviews and one joint interview with two carers); these interviews were followed by a focus group with six carers. Study was based at 2 research sites in Northern Ireland: interviews in the rural north of the country and focus group in the suburban hinterland of its capital city. Seven themes (issues) were identified from the interviews: 1. Information 2. Communication with and between health professionals 3. Access to therapies 4. Preparation/training for caring at home 5. Family and friends 6. Own health and abilities 7. Worries about the future Bulley, C; Shiels, J; Wilkie, K and Salisbury, L. 2010 Disability and Rehabilitation Qualitative Study To explore the lived experiences of individuals and describe them using a phenomenological qualitative perspective. 10 stroke survivors and 8 carers. The focus here was on were on the carers only. 2 additional carers participated unexpectedly. All carers were white British and married to the stroke survivors. Phenomenological qualitative perspective. Interviews all took place in their own home. Questions were included that related to experiences of stroke. One overarching theme emerged: 1. Lives turned upside-down, with subthemes: Changes in domestic and caring workload. Increased cognitive and emotional impacts Reduced participation in life Changed expectation of life. O`Connell, B and Baker, L. 2004 International Journal of Nursing Practice Qualitative study To determine carers perspectives of their support and educational needs while caring for the stroke survivor within the acute hospital, rehabilitation and community settings. 37 carers; 14 carers recruited from the acute setting, 9 from the rehabilitation and 14 from the community. The majority of carers were spouses or partners, while others were children and close relatives. There were +F than M. Exploratory, descriptive design was used in this study. Face-to face or telephone interviews. Interviews were conducted using semi-structured format. Findings: 1. Carer uncertainty 2. Coping strategies- remaining positive 3. Adapting to change 4. Comparison with others 5. Employment changes 6. Humour 7. Switching off 8. Support of family and friends. Read More