Volume 29, Issue 2 ,2007
Education in stroke prevention: Efficacy of an educational counselling intervention to increase knowledge in stroke survivors
By Theresa Green, Eryka Haley, Michael Eliasziw and Keith Hoyte
Background: Motivational interviewing and stages of change are approaches to increasing knowledge and effecting behavioural change. This study examined the application of this approach on stroke knowledge acquisition and changing individual lifestyle risk factors in an outpatient clinic.
Methods: RCT in which 200 participants were allocated to an education-counselling interview (ECI) or a control group. ECI group participants mapped their individual risk factors on a stage of change model and received an appointment to the next group lifestyle class. Participants completed a stroke knowledge questionnaire at baseline (T1), post-appointment, and three months (T3) post-appointment. Passive to active changes in lifestyle behaviour were self-reported at three months.
Results: There was a statistically significant difference between groups from T1 toT3 in stroke knowledge (p< 0.001). While there was a significant shift from a passive to active stage of change for the overall study sample (p<0.000), there was no significant difference between groups on the identified risk factors.
Conclusions: Although contact with patients in ambulatory clinical settings is limited due to time constraints, it is still possible to improve knowledge and initiate lifestyle changes utilizing motivational interviewing and a stage of change model. Stroke nurses may wish to consider these techniques in their practice setting.
Brain Tumour Foundation Award 2007 Glomus jugulare tumours: Are they really so benign?
By Wendy Blackburn, Grace Leung and Catherine Morash
Glomus jugulare tumours are rare, hypervascular and usually benign tumours involving the skull base. Diagnosis can be significantly delayed due to the slow and insidious clinical presentation. The primary manifestations involve auditory and lower cranial nerve deficits. Treatment options may include surgery, radiation and embolization. Surgery is the optimal treatment modality, but is not without serious potential complications. These complications are linked to the location and vascular nature of the tumour. Glomus jugulare tumours present a significant diagnostic and management challenge to all members of the health care team.
Barriers and facilitators to caring for individuals with stroke in the community: The family’s experience
By Carole L. White, Nicol Korner-Bitensky, Nathalie Rodrigue, Christina Rosmus, Rosa Sourial, Sylvie Lambert and Sharon Wood-Dauphinee
Purpose: This project explored caregivers’ perceptions regarding the barriers and facilitators to undertaking the post-stroke caregiving role, particularly as related to the health care system, with the ultimate goal of identifying potential strategies that would assist families in successfully undertaking the role.
Method: A qualitative study consisting of focus groups and individual interviews with caregivers of persons with stroke. Participants were asked about their needs in managing the care of their family member and the factors that facilitated and/or hindered the transition to the home and influenced them in maintaining their role.
Results: Information from 14 caregiver participants identified the following as primary barriers to undertaking and maintaining the caregiving role: lack of collaboration with the health care team, the intensity of the caregiving role, the negative impact on the caregiver, and the lack of community support for the caregiving role. Caregivers identified the following factors as facilitative: coordination of care, progress of the patient towards normalcy, mastery of the caregiving role, supportive social environment, and accessible communityresources.
Discussion and conclusions: The results indicate there are facilitators that caregivers perceive as important both to undertaking and to sustaining the caregiving role. Consideration of these results in the design of interventions may lead to more effective interventions to support caregivers in undertaking and continuing in the caregiver role.
Key words: family caregiving, stroke, facilitators, barriers, health care system, interventions