Medicine and Health Sciences Commons^™

Multimodal Secondary Prevention Behavioral Interventions For Tia And Stroke: A Systematic Review And Meta-Analysis., Maggie Lawrence

Dr. Maggie Lawrence

Background Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions.

Strategy Searches were conducted in 14 databases, including MEDLINE (1980-January 2014). We included randomized controlled trials (RCTs) testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines.

Results Twenty-three papers reporting 20 RCTs (6,373 participants) of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. …

The Effectiveness Of Secondary Prevention Lifestyle Interventions Designed To Change Lifestyle Behavior Following Stroke: Summary Of A Systematic Review, Maggie Lawrence, Susan Kerr, Caroline Mcvey, John Godwin

Dr. Maggie Lawrence

Background A feature of stroke is that it recurs (25% within

five-years). Risk factors for stroke and recurrent stroke

include smoking, alcohol consumption, poor diet, and physical

inactivity.

Aim To evaluate the effectiveness of secondary prevention

lifestyle interventions designed to change lifestyle behavior

following stroke. This short paper presents a summary of the

systematic review process and findings.

Methods Ten major databases were searched using subject

headings and key words. Papers were screened using

review-specific criteria. Critical appraisal and data extraction

were conducted independently by two reviewers. Data were

pooled in statistical meta-analysis; where this was not possible

findings were …

Defining And Measuring Patient-Centred Care: An Example From A Mixed Methods Systematic Review Of The Stroke Literature., Maggie Lawrence, Sue Kinn

Dr. Maggie Lawrence

Background

Involving patients in the determination of their care is increasingly important, and healthcare professionals worldwide have recognised a need for clinical outcome measures and interventions that facilitate patient-centred care delivery in a range of settings.

Aim

A mixed-methods review was conducted, which aimed to identify stroke-specific patient-centred outcome measures, patient-centred interventions, and family-centred interventions.

Search strategy

Databases searched included MEDLINE and PsycINFO; search strings were based on MeSH terms and keywords associated with the terms ‘stroke’ and ‘patient-centred’.

Data extraction and analysis

Descriptive statistics were used to report quantitative data; papers included in the review were also underwent thematic …

Pirandello’S Analogy: A Source For A Better Understanding Of The Social Impact Of Stroke, M.A.C. Van Haaren, Maggie Lawrence, P.H. Goossens, B. Van Den Bossche, M.J.H. Wermer, A.A. Kaptein

Dr. Maggie Lawrence

Background: Suffering a stroke has major implications for the patient. To understand human suffering, one should understand society. Pirandello described society as a higher entity than the individual, thereby justifying human adaptability to society. We explore a qualitative finding that suggests that social trends may influence how stroke patients prioritize aspects of their rehabilitation. Methods: We compare a contemporary patient’s experience of stroke recovery with that of a fictional character from the works of Luigi Pirandello. Both patients had two main residual symptoms: hemiparesis and aphasia. Results: The rehabilitation priorities of the two patients differed, and appeared to reflect the …

Determining The Needs, Priorities, And Desired Rehabilitation Outcomes Of Young Adults Who Have Had A Stroke, Maggie Lawrence, Sue Kinn

Dr. Maggie Lawrence

Background: Guidelines state that young adults’ rehabilitation needs and priorities following stroke are different from older adults’. However, there is a lack of evidence regarding young adults’ perspectives of their needs and priorities.

Aims: To gain an understanding of young adults’ experience of stroke and associated rehabilitation needs, priorities and desired outcomes.

Methods: Longitudinal data were gathered using unstructured interviews and analysed using phenomenological reduction.

Results: Ten young adults took part in up to four interviews over two years. An overarching theme, Embodied Disorientation, and three sub-themes: Mortal Body, Situated Body, and Embodied Perception of Difference, described the young adults’ …

The Lisbeth Hockey Community Nursing Research Training Fellowship 2008. Final Report, Maggie Lawrence, Susan Kerr, Caroline Mcvey, Dorothy Ferguson

Dr. Maggie Lawrence

Background Stroke is the most common cause of adult disability in the UK; the incidence is particularly high in Scotland, with more than 12,000 new cases per year. Stroke recurs in approximately 25% of patients and may result in death or an increased risk of disability or institutionalisation. Stroke is associated with a disadvantaged socio-economic profile and lifestyle behaviours which include smoking, unhealthy diet, excessive alcohol consumption and lack of exercise. Crucially, these factors are amenable to change by means of pharmacotherapy and/or the delivery of lifestyle interventions. While the provision of lifestyle interventions has the potential to improve health …

What Is The Evidence For Using Family Based Interventions To Prevent Stroke Recurrence?, Maggie Lawrence, Caroline Mcvey, Susan M. Kerr

Dr. Maggie Lawrence

Stroke has a devastating impact on individuals and families. Risk factors for recurrence include lifestyle behaviours such as smoking, excessive alcohol consumption, an unhealthy diet and physical inactivity. This article describes a programme of research that aims to gather and synthesise the evidence required to inform the development and evaluation of a family centred, behavioural intervention designed to address lifestyle risk factors for recurrent stroke. We present an overview of the research undertaken to develop the evidence base. This included a survey of stroke nurse practice, a focus group study with people who had had a stroke as well as …

Young Adults’ Experience Of Stroke: A Qualitative Review Of The Literature, Maggie Lawrence

Dr. Maggie Lawrence

Stroke is a life-threatening event that has a devastating impact on young adults and their families. The author conducted a systematic review of the qualitative literature to explore the experience of stroke from the perspective of young adults. Four primary research 'papers' were analyzed using the Qualitative Assessment and Review Instrument; 60 findings were extracted from the papers and merged into 13 categories, from which three synthesized findings were developed - disorientation, disrupted sense of self, and roles and relationships.

An Exploration Of Lifestyle Beliefs And Lifestyle Behaviour Following Stroke: Findings From A Focus Group Study Of Patients And Family Members, Maggie Lawrence, Susan M. Kerr, Hazel E. Watson, Gillian Paton, Graham Ellis

Dr. Maggie Lawrence

Stroke is a major cause of disability and family disruption and carries a high risk of recurrence. Lifestyle factors that increase the risk of recurrence include smoking, unhealthy diet, excessive alcohol consumption and physical inactivity. Guidelines recommend that secondary prevention interventions, which include the active provision of lifestyle information, should be initiated in hospital, and continued by community-based healthcare professionals (HCPs) following discharge. However, stroke patients report receiving little/no lifestyle information.

There is a limited evidence-base to guide the development and delivery of effective secondary prevention lifestyle interventions in the stroke field. This study, which was underpinned by the Theory …

Stroke Research Questions: A Nursing Perspective., Anne Rowat, Maggie Lawrence, Dorothy Horsburgh, Lynne Legg, Lorraine Smith

Dr. Maggie Lawrence

No abstract provided.