Yunhua Fang1, Qian Tao2, Xiaoxuan Zhou1, Shanjia Chen1, Jia Huang1, Yingping Jiang3, Yi Wu4, Lidian Chen5, Jing Tao6, Chetwyn C Chan7. 1. College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China. 2. Department of Psychology, School of Medicine, Jinan University, Guangzhou, China; Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. 3. Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Urumqi Municipality, China. 4. The Affiliated Huashan Hospital of Fudan University, Shanghai, China. 5. College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China; Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China. Electronic address: cld@fjtcm.edu.cn. 6. College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China; Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China. 7. Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Abstract
OBJECTIVE: To investigate how family members' attitudes toward functional regain, and patients' knowledge and intention of independence influence poststroke rehabilitation. DESIGN: Cross-sectional study. SETTING: Three rehabilitation inpatient settings. PARTICIPANTS: Younger (n=79) and older (n=84) poststroke patients, along with their family members (spouses, n=104; children, n=59). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Custom-designed questionnaires were used to tap into the patients' knowledge about rehabilitation (Patient's Rehabilitation Questionnaire-Knowledge About Rehabilitation) and intention of independence (Patient's Rehabilitation Questionnaire-Intention of Independence), and family members' attitudes toward patients in performing basic activities of daily living (BADL) (Family Member Attitudes Questionnaire-BADL) and instrumental activities of daily living (Family Member Attitudes Questionnaire-instrumental activities of daily living). The rehabilitation outcomes included gains in motor, cognitive, and emotional functions, and self-care independence, measured with common clinical instruments. RESULTS: The Family Member Attitudes Questionnaire-BADL predicted cognitive outcome and the Patient's Rehabilitation Questionnaire-Intention of Independence predicted motor outcome for both groups. Differential age-related effects were revealed for the Patient's Rehabilitation Questionnaire-Intention of Independence in predicting emotional outcome only for the younger group, and self-care independence only for the older group. CONCLUSIONS: Patients' intention of independence positively affected motor recovery, while family members' positive attitudes promoted cognitive regain. The findings suggested plausible age-related differences in how patients' intentions affect emotion versus self-care independence outcomes. Future studies should explore strategies for promoting positive attitudes toward independence among patients and family members during poststroke rehabilitation.
OBJECTIVE: To investigate how family members' attitudes toward functional regain, and patients' knowledge and intention of independence influence poststroke rehabilitation. DESIGN: Cross-sectional study. SETTING: Three rehabilitation inpatient settings. PARTICIPANTS: Younger (n=79) and older (n=84) poststroke patients, along with their family members (spouses, n=104; children, n=59). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Custom-designed questionnaires were used to tap into the patients' knowledge about rehabilitation (Patient's Rehabilitation Questionnaire-Knowledge About Rehabilitation) and intention of independence (Patient's Rehabilitation Questionnaire-Intention of Independence), and family members' attitudes toward patients in performing basic activities of daily living (BADL) (Family Member Attitudes Questionnaire-BADL) and instrumental activities of daily living (Family Member Attitudes Questionnaire-instrumental activities of daily living). The rehabilitation outcomes included gains in motor, cognitive, and emotional functions, and self-care independence, measured with common clinical instruments. RESULTS: The Family Member Attitudes Questionnaire-BADL predicted cognitive outcome and the Patient's Rehabilitation Questionnaire-Intention of Independence predicted motor outcome for both groups. Differential age-related effects were revealed for the Patient's Rehabilitation Questionnaire-Intention of Independence in predicting emotional outcome only for the younger group, and self-care independence only for the older group. CONCLUSIONS:Patients' intention of independence positively affected motor recovery, while family members' positive attitudes promoted cognitive regain. The findings suggested plausible age-related differences in how patients' intentions affect emotion versus self-care independence outcomes. Future studies should explore strategies for promoting positive attitudes toward independence among patients and family members during poststroke rehabilitation.
Authors: Shilpa Tyagi; Gerald Choon-Huat Koh; Nan Luo; Kelvin Bryan Tan; Helen Hoenig; David Bruce Matchar; Joanne Yoong; Angelique Chan; Kim En Lee; Narayanaswamy Venketasubramanian; Edward Menon; Kin Ming Chan; Deidre Anne De Silva; Philip Yap; Boon Yeow Tan; Effie Chew; Sherry H Young; Yee Sien Ng; Tian Ming Tu; Yan Hoon Ang; Keng He Kong; Rajinder Singh; Reshma A Merchant; Hui Meng Chang; Tseng Tsai Yeo; Chou Ning; Angela Cheong; Chuen Seng Tan Journal: BMJ Open Date: 2020-04-23 Impact factor: 2.692