Evolution of the Caregiving Experience in the Initial 2 Years Following Stroke

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What is the purpose of the study?

Here, the purpose of the study was to describe the characteristics of caregivers which include physical health symptoms, burden, HRQL (High related quality of life), and overall quality of life (QoL), in the first and second years of caregiving. The second purpose was to compare the caregivers’ HRQL in the first and second years of caregiving to age and sex-adjusted population norms. The third purpose was to determine the influence of stroke survivor characteristics and caregiver characteristics on HRQL. The final purpose was to examine the influence of stroke survivor characteristics and caregiver characteristics on the overall QoL. The content related to purpose was found in the introduction part of the research article.

Purpose statement in a PICO format and search strategy

To restate in PICO format, the purpose of the study was to determine the outcome of stroke patients’ QoL and overall HRQL characteristics by considering the caregiver characteristics like age physical health symptoms, burden and also comparing and studying their impact on patients QoL. This could work as an intervention strategy to improve the QoL of patients with stroke. CINAHL database was accessed and the research articles were retrieved from Pubmed. The articles used for supporting this part of the description were mentioned in the list of CINAHL Plus journals database

It was reported that family members, who are otherwise considered caregivers play a beneficial role in extending their support (Mant et al., 2005). This was revealed when a random follow-up controlled trial of family support for stroke patients was carried out to determine the efficacy of the intervention when it occurs early or late. It was found that family support was needful for carers (Mant et al., 2005). This may in turn help to address the problems associated with the QoL of stroke patients.

This has strengthened a recent report on the influence of caregivers on the emotional and physical activity of stroke patients. Stroke patients when discharged from hospitals would be in urgent need of the ability of carers to manage their depression, functional ability, and quality of life (Ski & Conell, 2007). But this strategy would get affected if a poor follow-up procedure was initiated at home. This study also highlighted that the demands on caregivers would increase following the early discharge of stroke patients which might, in turn, affect the rehabilitation process (Ski & Conell, 2007). It is reasonable to mention that these sources could be better regarded as evidence to support the indispensable role of caregivers in influencing the QoL of stroke survivors.

What is the focus of the study?

The focus of the study is to evaluate the relationship between the caregivers’ support and the QoL of stroke patients’ characteristics and to understand the long-term impact of stroke on individuals experiencing a stroke. This is because the etiologic factors were better attributed to the cascade of events that disable the stroke patients after discharge. The magnitude of normal life restored would help in assessing the care provider’s assistance. Further, the Barthel Index used to assess the stroke survivors’ functional status may also serve to provide prognostic information on stroke survivors’ overall characteristics (White et al, 2003).

Hence, determination of QoL by numerical scale method would help in the easy diagnosis of caregiver characteristics that is important to manage stroke patients (White et al, 2003). So, the prevention strategies would largely depend on the role of families to functionally dependent members. This would also enable to prevent and treat health problems especially emotional disturbances among caregivers which could ultimately benefit stroke patients (White et al, 2003).

Is the study qualitative or quantitative?

This study seems to be qualitative as it relies on various indices and measures used to validate the relationships, characteristics of caregivers and outcome of stroke patients.

Are research questions or hypotheses given?

Yes. The hypothesis mentioned in the article appears to be directional as it stated that “care giving would like to continue”. Keeping in view of the earlier drawbacks on diminished QoL and HRQL, the hypothesis is indicating a suggested role of caregivers in a specific way that could impact stroke patients (White et al., 2003).

What are the variables/ phenomena being studied?

The variables studied are QOL and HRQL. As they are related to the evaluation of emotional disturbances like anxiety and depression they fall under DSM IV criteria.

How does the author establish the importance of the study?

Next, the importance of the study was established by considering the percentage of stroke patients who were facing the disabilities in a sequel, by highlighting the discrepancies connected to within-person relationship variations and health improvements, focusing on earlier cross-sectional studies that have limited the information on the role of caregivers.

So, the importance of the study was mentioned in the introduction part.

How many paragraphs were used in the literature? What are the major topics? What are headings are used in the literature review? There was a total of nine paragraphs used and the major topics include stroke survivors, caregiving role, QoL and HRQL, psychiatric morbidity, stability for the stroke survivors, a summary of earlier reports. However, there were no specific headings.

Is a theoretical framework used?

The theoretical framework used was based on a nursing model named ‘Family Nursing’ but here or is not written by a nurse.

How many references are given in the reference list?

There was a total of 64 references and most of them were not current and 8 appear to be mostly published in nursing journals.

Research design with the identified characteristic?

The research design consisted of recruiting and interviewing the participants, including baseline values like age, sex, functional independence, Barthel index, communication problems, destination from acute care, relationship to the stroke survivor, living in the same house with stroke survivor, employment, and prevalent health problems (White et al., 2003).

References

Carole L. White, Nancy Mayo, James A Hanley, Sharon Wood-Dauphinee. (2003). Research in Nursing & Health, 26, 177-189.
Mant, J., Winner, S., Roche, J., Wade, D.T. (2005). Family support for stroke: one year follow up of a randomised controlled trial. J Neurol Neurosurg Psychiatry,76, 1006-8.
Ski, C, & Connell, O, B. (2007). Stroke: the increasing complexity of carer needs. J Neurosci Nurs, 39,172-9.
Jumisko, E., Lexell, J., Söderberg, S. (2007). Living with moderate or severe traumatic brain injury: the meaning of family members’ experiences. J Fam Nurs, 13,353-69.
Duff, D. (2006). Family impact and influence following severe traumatic brain injury. Axone, 27, 9-23.
Elaine Bond, A., Christy Rae Lee Draeger, Barbara Mandleco, Michael Donnelly.(2003).Critical Care Nurse, 23,63-71.

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