Cardiovascular Conditions
http://hdl.handle.net/20.500.12904/94
2024-03-28T09:44:39Z
2024-03-28T09:44:39Z
A scoping review of remote group-based psychological interventions for people after transient ischemic attack and stroke
Kontou, Eirini
Lee, Abigail R.
Thorpe, Naomi
http://hdl.handle.net/20.500.12904/18189
2024-01-30T15:56:31Z
2024-01-01T00:00:00Z
A scoping review of remote group-based psychological interventions for people after transient ischemic attack and stroke
Kontou, Eirini; Lee, Abigail R.; Thorpe, Naomi
Background Mental health and quality of life are commonly affected following a stroke or Transient Ischemic Attack (TIA) diagnosis, although many people are discharged without clear information about their psychological impact. Evidence suggests psychological interventions can be successfully delivered via remote methods (e.g. videoconferencing, telephone). However, it is unclear whether such interventions are effective for people post-stroke/TIA. This scoping review aimed to identify current evidence for remote group-based psychological interventions for people following TIA and stroke. Methods Four electronic databases (MEDLINE, Embase, PsycINFO, Scopus) were searched for articles on online group psychological interventions post-TIA and stroke. Four reviewers independently screened titles, abstracts and full texts, then two authors extracted data for included studies. A bespoke data extraction form was used to describe interventions, informed by Template for Intervention Description and Replication (TIDieR) checklists. Results The search yielded 1333 studies, from which six were included in the review. Four were feasibility studies (two randomised controlled trials, two single-group pre-/post-design). All interventions targeted stroke survivors; no studies targeted people with TIA. Delivery methods included teleconferencing, videoconferencing, an online platform (virtual multiuser world) and a hybrid approach using videoconferencing and face-to-face visits. Remote intervention components were delivered in the community or at participants’ homes. All studies included a mood measure. Improvement in mood and/or quality of life was reported across the four studies. Conclusions More research is needed to explore and confirm the potential benefits of remote delivery of group psychological interventions following stroke and TIA. Better reporting of implementation barriers/facilitators and more high-quality research are required to determine the effectiveness of remote interventions.
2024-01-01T00:00:00Z
Perceptions of post- stroke fatigue among health care practitioners: A qualitative interview study
Kontou, Eirini
http://hdl.handle.net/20.500.12904/18068
2024-01-26T15:21:28Z
2023-01-01T00:00:00Z
Perceptions of post- stroke fatigue among health care practitioners: A qualitative interview study
Kontou, Eirini
Background and Objectives: Post-Stroke Fatigue (PSF) is a complex, multidimensional, debilitating condition that affects almost half of all stroke survivors. This study explored the perceptions of physiatrists, physiotherapists, and occupational therapists about PSF and their experiences in managing patients with PSF in Saudi Arabia. Materials and Methods: Qualitative semi-structured interviews were conducted with participants from three different groups: eight physiotherapists (PTs), eight occupational therapists (OTs), and eight physiatrists (DRs). Using purposive sampling, participants with at least one year of experience in the field of PSF management were invited to take part. The data were analysed using inductive thematic analysis. Results: Twenty-four health care participants (eight PTs, eight OTs, eight DRs) were recruited. Five overarching themes encompassing various subthemes and sub-subthemes were generated: 'knowledge about post-stroke fatigue', 'diagnosing post-stroke fatigue', 'treatment approach', 'lack of awareness about post-stroke fatigue', and 'domains to improve'. The data indicated that participants used various strategies to manage PSF, including dietary changes, sleep hygiene, exercise, and energy conservation. Conclusions: Participants acknowledged that they lacked PSF-related management skills, despite possessing adequate knowledge about the management of stroke. Their openness to participating in activities that would improve their ability to diagnose and manage PSF was particularly striking.
© 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
2023-01-01T00:00:00Z
Psychological support after stroke: Unmet needs and workforce requirements of clinical neuropsychological provision for optimal rehabilitation outcomes
Kontou, Eirini
http://hdl.handle.net/20.500.12904/17992
2024-01-26T15:06:36Z
2023-01-01T00:00:00Z
Psychological support after stroke: Unmet needs and workforce requirements of clinical neuropsychological provision for optimal rehabilitation outcomes
Kontou, Eirini
Stroke services must detect and manage psychological and neuropsychological problems that occur after stroke, such as cognitive and language impairments, post-stroke apathy, post-stroke emotionalism, depression, anxiety, post-traumatic stress disorder, personality changes and suicidality. Stroke neuropsychology plays a key role in the assessment, understanding and management of these consequences of stroke, as well as contributing to complex case management, staff supervision and training. Where these provisions are absent from the stroke rehabilitation pathway, this significantly limits potential rehabilitation outcomes. To manage the scale of psychological and neuropsychological needs post stroke, clinical guidance recommends the use of a matched care system, in which these needs are triaged and matched with corresponding levels of support. Recent workforce guidelines provide clear professional recommendations for psychological staffing skill mix and threshold requirements for clinical oversight and clinical governance assurances.
2023-01-01T00:00:00Z
Effects of dietary-based weight loss interventions on biomarkers of endothelial function: a systematic review and meta-analysis
Stephan, Blossom C. M.
http://hdl.handle.net/20.500.12904/17651
2023-10-02T15:32:18Z
2023-01-01T00:00:00Z
Effects of dietary-based weight loss interventions on biomarkers of endothelial function: a systematic review and meta-analysis
Stephan, Blossom C. M.
Endothelial dysfunction is closely linked to the development of atherosclerosis. This systematic review and meta-analysis reviewed the evidence on the effect of weight loss, achieved by dietary-based interventions, on biomarkers of endothelial function (EF). Two databases (Medline, Embase) were searched from inception until November 2022 for studies that met the following criteria: 1) adult subjects (≥ 18 years) without exclusion for health status, 2) dietary interventions for weight loss, and 3) measurements of changes in EF biomarkers. Random-effect meta-analysis and meta-regression were performed. Thirty-seven articles including 1449 participants were included in the systematic review. Study duration ranged from 3-52 weeks. Overall, weight loss significantly improved biomarkers of EF [standardised mean difference (SMD):0.65; 95%CI:0.49,0.81; P < 0.001;I(2) = 91.9%]. Subgroup analyses showed weight loss significantly improved levels of E-selectin (P < 0.001), intercellular adhesion molecule-1 (ICAM-1) (P < 0.001), vascular cell adhesion molecule-1 (VCAM-1) (P < 0.001), nitrite/nitrate (NOx) (P < 0.001) and vascular endothelial growth factor (VEGF) (P < 0.001). Conversely, there was no significant improvement for von Willebrand Factor (vWF). Meta-regression analysis revealed that changes in EF biomarkers were not affected by age, BMI, quality of the studies or the amount of weight lost. A significant heterogeneity was observed for the effects of weight loss on changes in EF biomarkers. Dietary-induced weight loss may be associated with biomarkers changes indicating an improvement of EF, and it may represent a potential strategy to reduce atherosclerotic risk.
2023-01-01T00:00:00Z