Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis.
Date
2021-04
Journal Title
Journal ISSN
Volume Title
Citation Stats
Attention Stats
Abstract
Objectives
To identify and describe caregiver profiles based on their psychosocial health characteristics over a 12-month period and transitions among these profiles, to determine if stroke rehabilitation use at 12 months post-stroke differed by caregiver profile transition patterns, and to investigate if caregiver profiles at 3 months post-stroke moderate the association of stroke rehabilitation use at 3 months and 12 months post-stroke after accounting for covariates.Design
Latent profile transition analysis of caregiver psychosocial health with stroke rehabilitation use at 12 month post-stroke as outcome.Setting
and Participants: A total of 149 stroke patient-caregiver dyads from the Singapore Stroke Study.Methods
Cross-sectional latent profile analyses were conducted on caregiver psychosocial health indicators of burden, depression, health status, quality of relationship with patient, and social support. Changes in latent profile classification over 3 time points (baseline, 3 months, and 12 months post-stroke) were analyzed using latent transition analysis. A transition model with stroke rehabilitation use at 12 months post-stroke as the outcome was tested after accounting for covariates.Results
Two distinct caregiver psychosocial health latent profiles were found across time: nondistressed and distressed. Most caregivers were classified as nondistressed and remained nondistressed over time. Distressed caregivers at baseline were 76% likely to become nondistressed at 12 month post-stroke. Regardless of profile transition patterns, nondistressed caregivers at 12 months post-stroke tended to have cared for stroke rehabilitation nonusers at 12 months post-stroke. Patient depression explained profile classification at 3 months and 12 months post-stroke. After accounting for covariates, rehabilitation users at 3 months post-stroke tended to continue using rehabilitation at 12 months post-stroke only when they had nondistressed caregivers at 3 months post-stroke.Conclusions and implications
Whether caregiver adaptation explains the associations between the latent profile transition patterns and rehabilitation use at 12 months post-stroke should be examined. Early psychosocial health assessment and sustained support should be made available to stroke caregivers to enhance their well-being and subsequent patient rehabilitation participation.Type
Department
Description
Provenance
Subjects
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Chong, Wayne FW, Leong Hwee Ng, Ringo M-H Ho, Gerald CH Koh, Helen Hoenig, David B Matchar, Philip Yap, Narayanaswamy Venketasubramanian, et al. (2021). Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis. Journal of the American Medical Directors Association. 10.1016/j.jamda.2021.02.036 Retrieved from https://hdl.handle.net/10161/22731.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke
Helen Marie Hoenig
- General Focus and Goals of Research: Dr. Hoenig's research career centered on geriatric rehabilitation, and included use of technology to ameliorate disability, improving access to care via telerehabilitation, and developing key conceptual models to guide rehabilitation practices. She led work diverse novel approaches to care across the Veterans Health System, including the development and implementation of the VA Spinal Cord Injury & Disorders Registry and the Asynchronous Telehealth My VA Images mobile app. Dr. Hoenig has been involved in global health research on telerehabilitation, community mobility and global rehabilitation needs. Currently, Dr. Hoenig is enrolled in the Hybrid mDiv Program at Duke Divinity School to explore the interface of science, art and theology.
- Specific Approaches or Techniques: Randomized controlled trials, large database analyses and survey research. Her clinical research included studies on rehabilitation intervention studies (e.g., provision of mobility aids) and novel ways to improve access to rehabilitation (e.g., group physical therapy, telerehabilitation). Epidemiological studies and survey research have examined factors exacerbating or ameliorating disability, including medical complications such as fractures, environmental factors, use of assistive technology, and daily activity participation. Her research has ranged from single and multisite studies, to nationwide epidemiological studies, and global health research.
- Special areas of expertise/national recognition: Rehabilitation health services research, geriatric rehabilitation, assistive technology outcomes, telerehabilitation.
KEY WORDS/PHRASES: Rehabilitation, Telehealth, Geriatrics, Disability. Art, Theology
David Bruce Matchar
My research relates to clinical practice improvement - from the development of clinical policies to their implementation in real world clinical settings. Most recently my major content focus has been cerebrovascular disease. Other major clinical areas in which I work include the range of disabling neurological conditions, cardiovascular disease, and cancer prevention.
Notable features of my work are: (1) reliance on analytic strategies such as meta-analysis, simulation, decision analysis and cost-effectiveness analysis; (2) a balancing of methodological rigor the needs of medical professionals; and (3) dependence on interdisciplinary groups of experts.
This approach is best illustrated by the Stroke Prevention Patient Outcome Research Team (PORT), for which I served as principal investigator. Funded by the AHCPR, the PORT involved 35 investigators at 13 institutions. The Stroke PORT has been highly productive and has led to a stroke prevention project funded as a public/private partnership by the AHCPR and DuPont Pharma, the Managing Anticoagulation Services Trial (MAST). MAST is a practice improvement trial in 6 managed care organizations, focussing on optimizing anticoagulation for individuals with atrial fibrillation.
I serve as consultant in the general area of analytic strategies for clinical policy development, as well as for specific projects related to stroke (e.g., acute stroke treatment, management of atrial fibrillation, and use of carotid endarterectomy.) I have worked with AHCPR (now AHRQ), ACP, AHA, AAN, Robert Wood Johnson Foundation, NSA, WHO, and several pharmaceutical companies.
Key Words: clinical policy, disease management, stroke, decision analysis, clinical guidelines
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.