Disability and rehabilitation
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Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions. ⋯ Post-stroke self-management is a learning process with different levels dependent on pre-stroke lifestyle and self-management skills, the post-stroke phase of recovery, the cognitive abilities of stroke survivors and the support of caregivers (co-management). Persons with cognitive impairments are not persons who cannot learn to self-manage; rather, they need more specific self-management support. Case studies describing the abilities of stroke survivors, who are successful in self-management post-stroke, can help to develop "ability oriented" stroke-illness scripts. Addressing "ability oriented" stroke-illness scripts in bachelor and post-graduate education will enhance positive professional beliefs concerning the self-management post-stroke, and will help professionals in coaching in stroke survivors' goal setting in self-management programmes. Professionals' account suggests that stroke self-management programmes should also be delivered post-discharge at stroke survivors' own homes.
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Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. ⋯ In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care. Suggested implementation strategies include local monitoring of guideline implementation (e.g. team meetings, audits), increasing collaboration on implementation projects (e.g. managerial involvement, networking), and seeking speech pathologist input into guideline development.
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The aim of this study was to determine how school teachers in the United States (US) perceived using Twitter as a means for professional development, engagement in communities of practice, and any benefits or drawbacks to participating in Twitter. ⋯ Regardless of years teaching, subject area, or age, educators perceived Twitter as providing an online forum to reflect upon practice, exchange knowledge and experience, and be in the presence of supportive colleagues. While participants experienced the pace and volume of information as being overwhelming at times, educators developed skills to managing this and perceived discussions to be learner-centered and supportive. Teachers valued the sense of community and learning that they reported were not otherwise available in their own physical workplace. Overall, participants perceived that the benefits of participation in online Twitter chats for learning outweighed any drawbacks experienced. This article includes implications for future research and how social network sites may be used as a supportive venue for educators, therapists, and students, including individuals with disabilities.
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The purpose of this study is to describe thoughts and attitudes of patients with chronic obstructive pulmonary disease (COPD) when talking about exercise training as treatment. ⋯ Patients with COPD, with no previous experience of exercise training as treatment for their disease, describe exercise training as something unknown and unimportant for them. The results provide important knowledge for healthcare professionals regarding how to educate patients with COPD about the content and benefits of exercise training as treatment. Implications for Rehabilitation Exercise training is effective for patients with chronic obstructive pulmonary disease (COPD) with regard to dyspnea, physical capacity, health-related quality of life, and health care use. Patients with COPD perceive a lack of information regarding exercise training as treatment. The information and the presentation of exercise training as treatment might be of importance to get better adherence to this treatment.
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Randomized Controlled Trial
Transcranial direct current stimulation in the recovery of postural control after stroke: a pilot study.
This pilot study aimed to evaluate the effectiveness of multiple sessions of transcranial Direct Current Stimulation (tDCS) during 4 weeks on balance and gait parameters after stroke. ⋯ This pilot study indicates that 16 tDCS-sessions could have a beneficial effect on balance and gait in stroke patients measured with the Tinetti test. However, further research is needed to elucidate these findings. Implications for Rehabilitation Sixteen sessions of tDCS is beneficial in the recovery of postural control in stroke patients. tDCS has to be applied as soon as possible to enhance beneficial effects.