Background: Up to one third of all stroke patients suffer fromone or more psychosocial impairments. Recognition and treatment of these impairments are essential in improving psychosocial well-being after stroke. Although nurses are ideally positioned to address psychosocial well-being, they often feel insecure about providing the needed psychosocial care. Therefore, we expect that providing nurses with better knowledge to deliver this care could lead to an improvement in psychosocialwell-being after stroke. Currently it is not knownwhich interventions are effective and what aspects of these interventions are most effective to improve psychosocial wellbeing after stroke. Objective: To identify potentially effective interventions – and intervention components – which can be delivered by nurses to improve patients' psychosocial well-being after stroke. Methods: A systematic review and data synthesis of randomized controlled trials and quasi experimental studies was conducted. Papers were included according to the following criteria: 1) before-after design, 2) all types of stroke patients, 3) interventions that can be delivered by nurses, 4) the primary outcome(s) were psychosocial. PubMed, Embase, PsychInfo, CINAHL and Cochrane library were searched (August 2019–April 2022). Articles were selected based on title, abstract, full text and quality. Quality was assessed by using Joanna Briggs Institute checklists and a standardized data extraction form developed by Joanna Brigss Institute was used to extract the data. Results: In total 60 studies were included, of which 52 randomized controlled trials, three non-randomized controlled trials, four quasi-experimental studies, and one randomized cross-over study. Nineteen studies had a clear psychosocial content, twenty-nine a partly psychosocial content, and twelve no psychosocial content. Thirty-nine interventions that showed positive effects on psychosocial well-being after stroke were identified. Effective intervention topics were found to be mood, recovery, coping, emotions, consequences/problems after stroke, values and needs, risk factors and secondary prevention, self-management, andmedicationmanagement. Active information and physical exercise were identified as effective methods of delivery. Discussion: The results suggest that interventions to improve psychosocial well-being should include the intervention topics and methods of delivery that were identified as effective. Since effectiveness of the intervention can depend on the interaction of intervention components, these interactions should be studied. Nurses and patients should be involved in the development of such interventions to ensure it can be used by nurses and will help improve patients' psychosocial well-being.
Hospitalisation is stressful for children. Play material is often offered for distraction and comfort. Weexplored how contact with social robot PLEO could positively affect a child’s well-being. To this end, we performed a multiple case study on the paediatric ward of two hospitals. Child life specialists offered PLEO as a therapeutic activity to children in a personalised way for a well-being related purpose in three to five play like activity sessions during hospital visits/stay. Robot–child interaction was observed; care professionals, children and parents were interviewed. Applying direct content analysis revealed six categories of interest: interaction with PLEO, role of the adults, preferences for PLEO, PLEO as buddy, attainment of predetermined goal(s) and deployment of PLEO. Four girls and five boys, aged 4–13, had PLEO offered as a relief from stress or boredom or for physical stimulation. All but one started interacting with PLEO and showed behaviours like hugging, caring or technical exploration, promoting relaxation, activation and/or making contact. Interaction with PLEO contributed to achieving the well-being related purpose for six of them. PLEO was perceived as attractive to elicit play. Although data are limited, promising results emerge that the well-being of hospitalised children might be fostered by a personalised PLEO offer.
In the Netherlands, 125 people suffer a stroke every day, which annually results in 46.000 new stroke patients Stroke patients are confronted with combinations of physical, psychological and social consequences impacting their long term functioning and quality of live. Fortunately many patients recover to their pre-stroke level of functioning, however, almost half of them never will. Consequently, rehabilitation often means that patients need to adapt to a new reality in their lives, requiring not only physical but also psychosocial adjustments. Nurses play a key role during rehabilitation of stroke patients. However, when confronted with psychosocial problems, they often feel insecure about identifying the specific psycho-social needs of the individual patient and providing adequate care. In our project ‘Early Detection of Post-Stroke Depression’, (SIA RAAK; 2010-12-36P), we developed a toolkit focusing on early identification of depression after stroke continued with interventions nurses can use during hospitalisation. During this project it became clear that evidence regarding possible interventions is scarce and inclusive. Moreover feasibility of interventions is often not confirmed. Our project showed that during the period of hospital admission patients and health care providers strongly focus on surviving the stroke and on the physical rehabilitation. Therefore, we concluded that to make one step beyond we first have to go one step back. To strengthen psychosocial care for patients after stroke we have to add, reconsider and shape knowledge in context of health care practices in a systematic way, resulting in evidence based and practice informed stepping stones. With this project we aim to collect these stepping stones and develop a nursing care programme that improves psychosocial well-being of patients after stroke, is tailored to the particular concerns and needs of patients, and is considered feasible for use in the usual care process of nurses in the stroke rehabilitation pathway.
Patiënten zijn vaak zenuwachtig, gespannen en onzeker voor een ziekenhuisbezoek; en soms zijn ze zelfs ronduit angstig. Zorgen over de diagnose en/of de behandeling van hun ziekte kunnen daaraan ten grondslag liggen. Een goed gebouw kan hen daarbij helpen, bijvoorbeeld met een doordachte route, indeling en inrichting.Het doel van dit proefschrift was om een beter inzicht te krijgen in een holistische beleving en het welbevinden van patiënten in ziekenhuizen. Het onderzoek is gericht op specifieke aspecten van het gehele traject dat een patiënt aflegt, vanaf de aankomst tot en met de diagnose en de behandeling in een ziekenhuis. Daaruit bleek bijvoorbeeld dat patiënten soms lastig de weg kunnen vinden naar een polikliniek en dat natuurbeelden tijdens een CT-scan stress konden verminderen. Ook bleek dat sommige patiënten het prettig vonden om ter afleiding (de mogelijkheid tot) contact te hebben met andere patiënten, terwijl anderen dit juist vermoeiend vonden en de behoefte hadden aan afzondering tijdens een behandeling.De resultaten van dit proefschrift laten zien dat de ziekenhuisomgeving een grote impact heeft op het psychosociale en zelfs fysieke welbevinden van patiënten. Bij het ontwerpen van een ziekenhuisgebouw blijkt het van groot belang om te luisteren naar de ervaringen en behoeften van patiënten. Door het (her)ontwerp van de omgeving af te stemmen op de individuele kenmerken, behoeften en voorkeuren van patiënten kan hun welbevinden worden verbeterd. Anders gezegd, diversiteit en flexibiliteit zijn gevraagd!
