Dyadic approach to supervised community rehabilitation participation in an Asian setting post-stroke: exploring the role of caregiver and patient characteristics in a prospective cohort study.

dc.contributor.author

Tyagi, Shilpa

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Koh, Gerald Choon-Huat

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Luo, Nan

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Tan, Kelvin Bryan

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Hoenig, Helen

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Matchar, David Bruce

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Yoong, Joanne

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Chan, Angelique

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Lee, Kim En

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Venketasubramanian, Narayanaswamy

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Menon, Edward

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Chan, Kin Ming

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De Silva, Deidre Anne

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Yap, Philip

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Tan, Boon Yeow

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Chew, Effie

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Young, Sherry H

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Ng, Yee Sien

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Tu, Tian Ming

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Ang, Yan Hoon

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Kong, Keng He

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Singh, Rajinder

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Merchant, Reshma A

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Chang, Hui Meng

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Yeo, Tseng Tsai

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Ning, Chou

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Cheong, Angela

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Tan, Chuen Seng

dc.date.accessioned

2021-05-05T05:48:03Z

dc.date.available

2021-05-05T05:48:03Z

dc.date.issued

2020-04-23

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2021-05-05T05:48:03Z

dc.description.abstract

Objective

To study the association of caregiver factors and stroke survivor factors with supervised community rehabilitation (SCR) participation over the first 3 months and subsequent 3 to 12 months post-stroke in an Asian setting.

Design

Prospective cohort study.

Setting

Community setting.

Participants

We recruited stroke survivors and their caregivers into our yearlong cohort. Caregiver and stroke survivor variables were collected over 3-monthly intervals. We performed logistic regression with the outcome variable being SCR participation post-stroke.

Outcome measures

SCR participation over the first 3 months and subsequent 3 to 12 months post-stroke RESULTS: 251 stroke survivor-caregiver dyads were available for the current analysis. The mean age of caregivers was 50.1 years, with the majority being female, married and co-residing with the stroke survivor. There were 61%, 28%, 4% and 7% of spousal, adult-child, sibling and other caregivers. The odds of SCR participation decreased by about 15% for every unit increase in caregiver-reported stroke survivor's disruptive behaviour score (OR: 0.845; 95% CI: 0.769 to 0.929). For every 1-unit increase in the caregiver's positive management strategy score, the odds of using SCR service increased by about 4% (OR: 1.039; 95% CI: 1.011 to 1.068).

Conclusion

We established that SCR participation is jointly determined by both caregiver and stroke survivor factors, with factors varying over the early and late post-stroke period. Our results support the adoption of a dyadic or more inclusive approach for studying the utilisation of community rehabilitation services, giving due consideration to both the stroke survivors and their caregivers. Adopting a stroke survivor-caregiver dyadic approach in practice settings should include promotion of positive care management strategies, comprehensive caregiving training including both physical and behavioural dimensions, active engagement of caregivers in rehabilitation journey and conducting regular caregiver needs assessments in the community.
dc.identifier

bmjopen-2019-036631

dc.identifier.issn

2044-6055

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2044-6055

dc.identifier.uri

https://hdl.handle.net/10161/22769

dc.language

eng

dc.publisher

BMJ

dc.relation.ispartof

BMJ open

dc.relation.isversionof

10.1136/bmjopen-2019-036631

dc.subject

Humans

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Aftercare

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Patient Discharge

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Activities of Daily Living

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Longitudinal Studies

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Prospective Studies

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Cross-Sectional Studies

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Adult

dc.subject

Middle Aged

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Caregivers

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Female

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Male

dc.subject

Stroke

dc.subject

Stroke Rehabilitation

dc.title

Dyadic approach to supervised community rehabilitation participation in an Asian setting post-stroke: exploring the role of caregiver and patient characteristics in a prospective cohort study.

dc.type

Journal article

duke.contributor.orcid

Hoenig, Helen|0000-0002-6682-2627

duke.contributor.orcid

Matchar, David Bruce|0000-0003-3020-2108

pubs.begin-page

e036631

pubs.issue

4

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School of Medicine

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Duke Clinical Research Institute

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Duke Global Health Institute

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Pathology

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Medicine, General Internal Medicine

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Duke

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Institutes and Centers

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Clinical Science Departments

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Medicine

pubs.organisational-group

Center for the Study of Aging and Human Development

pubs.organisational-group

Medicine, Geriatrics

pubs.publication-status

Published

pubs.volume

10

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