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Frontiers in Neurology 2023Return-to-work is a key rehabilitation goal for many working aged stroke survivors, promoting an overall improvement of quality of life, social integration, and... (Review)
Review
INTRODUCTION
Return-to-work is a key rehabilitation goal for many working aged stroke survivors, promoting an overall improvement of quality of life, social integration, and emotional wellbeing. Conversely, the failure to return-to-work contributes to a loss of identity, lowered self-esteem, social isolation, poorer quality of life and health outcomes. Return-to-work programmes have largely focused on physical and vocational rehabilitation, while neglecting to include mood and fatigue management. This is despite the knowledge that stroke results in changes in physical, cognitive, and emotional functioning, which all impact one's ability to return to work. The purpose of this systematic review is to conduct a comprehensive and up-to-date search of randomised controlled trials (RCTs) of return-to-work programmes after stroke. The focus is especially on examining components of mood and fatigue if they were included, and to also report on the screening tools used to measure mood and fatigue.
METHOD
Searches were performed using 7 electronic databases for RCTs published in English from inception to 4 January 2023. A narrative synthesis of intervention design and outcomes was provided.
RESULTS
The search yielded 5 RCTs that satisfied the selection criteria ( = 626). Three studies included components of mood and fatigue management in the intervention, of which 2 studies found a higher percentage of subjects in the intervention group returning to work compared to those in the control group. The remaining 2 studies which did not include components of mood and fatigue management did not find any significant differences in return-to-work rates between the intervention and control groups. Screening tools to assess mood or fatigue were included in 3 studies.
CONCLUSION
Overall, the findings demonstrated that mood and fatigue are poorly addressed in rehabilitation programmes aimed at improving return-to-work after stroke, despite being a significant predictor of return-to-work. There is limited and inconsistent use of mood and fatigue screening tools. The findings were generally able to provide guidance and recommendations in the development of a stroke rehabilitation programme for return-to-work, highlighting the need to include components addressing and measuring psychological support and fatigue management.
PubMed: 37674875
DOI: 10.3389/fneur.2023.1145705 -
Patient Education and Counseling Jul 2023To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions... (Review)
Review
Addressing education and employment outcomes in the provision of healthcare for young people with physical long-term conditions: A systematic review and mixed methods synthesis.
OBJECTIVE
To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions (LTCs).
METHODS
We searched 10 bibliographic databases. Restrictions were applied on publication date (1996-2020) and language (English). Two reviewers independently screened records against eligibility criteria. Articles reporting relevant qualitative and/or quantitative research were included. Quality appraisal was undertaken following study selection. Qualitative data were synthesised thematically, and quantitative data narratively. A cross-study synthesis integrated qualitative and quantitative findings.
RESULTS
43 articles were included. Thematic synthesis of qualitative studies (n = 23) resulted in seven recommendations for intervention (psychological support; information/signposting; skills training; career advice; healthcare-school/workplace collaboration; social support; flexible/responsive care). The narrative synthesis summarised results of 17 interventions (n = 20 quantitative studies). The cross-study synthesis mapped interventions against recommendations. Transitional care was the intervention type that most comprehensively met our proposed recommendations.
CONCLUSIONS
Evidence from YP perspectives highlights that vocational development is an important area to address in healthcare provision. Robust intervention studies in this area are lacking.
PRACTICE IMPLICATIONS
Our evidence-based recommendations for intervention can support health professionals to better address vocational issues/outcomes. With minimal adaptations, transitional care interventions would be particularly well suited to deliver this.
Topics: Humans; Adolescent; Health Personnel; Educational Status; Social Support; Workplace; Delivery of Health Care
PubMed: 37086594
DOI: 10.1016/j.pec.2023.107765 -
Turk Gogus Kalp Damar Cerrahisi Dergisi Jan 2024In this meta-analysis, we aimed to systematically examine the relationship between body mass index and major adverse cardiovascular events in acute coronary syndrome...
BACKGROUND
In this meta-analysis, we aimed to systematically examine the relationship between body mass index and major adverse cardiovascular events in acute coronary syndrome patients and to provide theoretical guidance for body weight management in these patients.
METHODS
A comprehensive analysis of applicable research published between 2008 and 2021 was conducted using the PubMed, Cochrane, Web of Science, Wanfang, and CNKI databases. Extracted odds ratios from the randomized-controlled studies were pooled using fixed-effects meta-analysis. Publication bias was addressed through evaluation methods such as funnel plot or sensitivity analysis.
RESULTS
Ten studies with a total of 58,992 individuals were included. The consequences of this meta-analysis confirmed that, compared to normal body mass index, patients with acute coronary syndrome significantly increased the risk of major adverse cardiovascular events (odds ratio= 1.20; 95% confidence interval: 1.12-1.29, p<0.001).
CONCLUSION
Patients with acute coronary syndrome being overweight or obese significantly increased the risk of major adverse cardiovascular events compared to those with normal body mass index. The results suggest that patients may focus on weight management to reduce the risk of major adverse cardiovascular events in acute coronary syndrome.
PubMed: 38545361
DOI: 10.5606/tgkdc.dergisi.2024.24405 -
BMJ Open Feb 2024To review patient-report/caregiver-report measures of rehabilitation service use following acquired brain injury (ABI).
OBJECTIVE
To review patient-report/caregiver-report measures of rehabilitation service use following acquired brain injury (ABI).
DATA SOURCES
Medline, APA PsycINFO, Embase and CINAHL were searched on November 2021 and November 2022. Authors were contacted if measures were not included in manuscripts/appendices.
STUDY SELECTION
Included articles were empirical research or a research protocol, available in English and described measures of patient report/caregiver report of rehabilitation service use post-ABI via quantitative or qualitative methods. Two reviewers independently screened 5290 records using DistillerSR. Discrepancies were resolved by team adjudication.
DATA EXTRACTION
Data extraction was piloted with high levels of agreement (k=.94). Data were extracted by a single member with team meetings to seek guidance as needed. Data included administration characteristics (reporter, mode of administration, recall period), psychometric evidence and dimensions assessed (types of services, setting, frequency, duration, intensity, qualitative aspects).
DATA SYNTHESIS
One hundred and fifty-two measures were identified from 85 quantitative, 56 qualitative and 3 psychometric studies. Psychometric properties were reported for four measures, all of which focused on satisfaction. Most measures inquired about the type of rehabilitation services used, with more than half assessing functional (eg, physical therapy) and behavioural health rehabilitation services, but fewer than half assessing community and academic reintegration (eg, special education, vocational rehabilitation) or cognitive (eg, neuropsychology) services. Fewer than half assessed qualitative aspects (eg, satisfaction). Recall periods ranged from 1 month to 'since the ABI event' or focused on current use. Of measures that could be accessed (n=71), many included a limited checklist of types of services used. Very few measures assessed setting, frequency, intensity or duration.
CONCLUSIONS
Despite widespread interest, the vast majority of measures have not been validated and are limited in scope. Use of gold-standard psychometric methods to develop and validate a comprehensive patient-report/caregiver-report measure of rehabilitation service use would have wide-ranging implications for improving rehabilitation research in ABI.
Topics: Humans; Caregivers; Brain Injuries; Rehabilitation, Vocational; Psychiatry; Checklist
PubMed: 38382949
DOI: 10.1136/bmjopen-2023-076537