Browsing by Author "Harris, Gabrielle"
Results Per Page
Sort Options
Item Open Access Parenting After Stroke(2020) Harris, GabrielleStroke is the fifth leading cause of death in the United States and the leading cause of disability. Historically, stroke has been considered a condition limited to older adults. However, stroke is affecting an increasing number of young and middle-aged adults. Effects of stroke may be more profound for younger adults due to the disruption in their life course at a time focused on employment, family routines, and childcare responsibilities. Beyond paid employment, there is a paucity of research on resuming meaningful life roles such as parenting. Any impairment from stroke can make it difficult to be a parent to the same extent and level of engagement as before the stroke. As parenting is a critical life role with numerous responsibilities and challenges, the intersection of parenting and stroke recovery must be explored.
The purpose of this dissertation research was to develop a better understanding of how parenting both affects and is affected by the experience of having a stroke among younger stroke survivors. The research purpose was accomplished through a systematic review examining the state of the science on parenting after stroke (chapter 2), a qualitative study assessing the parenting experiences of 10 younger survivors following stroke (chapter 3), and a longitudinal concurrent convergent mixed methods study exploring the change in health-related quality of life and acute recovery experiences among 30 younger stroke survivors with targeted analyses to explore the role of parenting (chapter 4).
Parenting tasks were severely limited following stroke, though the specific duties impacted were dependent upon the age of the child. Stroke impairments disrupted survivors’ identities, relationships, and roles as parents as well as those of their families. Parents’ heightened concern for their children and an inability to consistently meet their needs may have affected their recovery. Support from family, friends, and extended networks was vital to survivors during the recovery process. However, difficulty in accepting dependence and variation in survivors’ relationship dynamics likely influenced the role of social support. Insurance and finances, often related to employment and income changes, were determinants of access to care following hospital discharge. Accessing care allowed survivors to engage with healthcare providers who helped them to improve and manage their impairments. Coping strategies influenced survivors’ adaptation post-stroke while their level of determination contributed to their engagement in rehabilitation activities. Finally, being of younger age influenced survivors’ experiences with stroke recognition, diagnosis, and recovery. Findings from this dissertation will be used to inform future studies seeking to improve the lives, well-being, and health of younger stroke survivors living with minor children.
Item Open Access Transitions of care interventions to improve quality of life among patients hospitalized with acute conditions: a systematic literature review.(Health and quality of life outcomes, 2021-01-29) Oyesanya, Tolu O; Loflin, Callan; Byom, Lindsey; Harris, Gabrielle; Daly, Kaitlyn; Rink, Lesley; Bettger, Janet PrvuBackground
Although transitional care interventions can improve health among patients hospitalized with acute conditions, few interventions use patient quality of life (QOL) as the primary outcome. Existing interventions use a variety of intervention components, are not effective for patients of all races and ethnicities, do not address age-related patient needs, and do not incorporate the needs of families. The purpose of this study was to systematically review characteristics of transitional care intervention studies that aimed to improve QOL for younger adult patients of all race and ethnicities who were hospitalized with acute conditions.Methods
A systematic review was conducted of empirical literature available in PubMed, Embase, CINAHL, and PsycINFO by November 19, 2019 to identify studies of hospital to home care transitions with QOL as the primary outcome. Data extraction on study design and intervention components was limited to studies of patients aged 18-64.Results
Nineteen articles comprising 17 studies met inclusion criteria. There were a total of 3,122 patients across all studies (range: 28-536). Populations of focus included cardiovascular disease, chronic obstructive pulmonary disease, stroke, breast cancer, and kidney disease. Seven QOL instruments were identified. All interventions were multi-component with a total of 31 different strategies used. Most interventions were facilitated by a registered nurse. Seven studies discussed intervention facilitator training and eight discussed intervention materials utilized. No studies specified cultural tailoring of interventions or analyzed findings by racial/ethnic subgroup.Conclusions
Future research is needed to determine which intervention components, either in isolation or in combination, are effective in improving QOL. Future studies should also elaborate on the background and training of intervention facilitators and on materials utilized and may also consider incorporating differences in culture, race and ethnicity into all phases of the research process in an effort to address and reduce any health disparities.