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Biomedical subjects

S Winner

Publications and source records attributed to S Winner.

10 recordsLinked to original sources
PubMed2005

Family support for stroke: one year follow up of a randomised controlled trial.

BACKGROUND: There is evidence that family support can benefit carers of stroke patients, but not the patients themselves. OBJECTIVE: To extend the follow up of a single blind randomised controlled trial of family support for stroke patients and carers to one year to ascertain whether there were any late effects of the intervention. METHODS: The study was a randomised controlled trial. Patients admitted to hospital with acute stroke who had a close carer were assigned to receive family support or normal care. Families were visited at home by a researcher 12 months after the stroke, and a series of questionnaires was administered to patient and carer. RESULTS: The benefits to carers mostly persisted, though they were no longer statistically significant because some patients were lost to follow up. There was no evidence of any effects on patients. CONCLUSION: Family support is effective for carers, but different approaches need to be considered to alleviate the psychosocial problems of stroke patients.

Adaptation, Psychological↗
PubMed2000

Family support for stroke: a randomised controlled trial.

BACKGROUND: Attention is currently focused on family care of stroke survivors, but the effectiveness of support services is unclear. We did a single-blind, randomised, controlled trial to assess the impact of family support on stroke patients and their carers. METHODS: Patients with acute stroke admitted to hospitals in Oxford, UK, were assigned family support or normal care within 6 weeks of stroke. After 6 months, we assessed, for carers, knowledge about stroke, Frenchay activities index, general health questionnaire-28 scores, caregiver strain index, Dartmouth co-op charts, short form 36 (SF-36), and satisfaction scores, and, for patients, knowledge about stroke and use of services, Barthel index, Rivermead mobility index, Frenchay activities index, London handicap scale, hospital anxiety and depression scales, Dartmouth co-op charts, and satisfaction. FINDINGS: 323 patients and 267 carers were followed up. Carers in the intervention group had significantly better Frenchay activities indices (p=0.03), SF-36 scores (energy p=0.02, mental health p=0.004, pain p=0.03, physical function p=0.025, and general health perception p=0.02), quality of life on the Dartmouth co-op chart (p=0.01), and satisfaction with understanding of stroke (82 vs 71%, p=0.04) than those in the control group. Patients' knowledge about stroke, disability, handicap, quality of life, and satisfaction with services and understanding of stroke did not differ between groups. Fewer patients in the intervention group than in the control group saw a physiotherapist after discharge (44 vs 56%, p=0.04), but use of other services was similar. INTERPRETATION: Family support significantly increased social activities and improved quality of life for carers, with no significant effects on patients.

Aged↗
PubMed2000

The London handicap scale: a re-evaluation of its validity using standard scoring and simple summation.

OBJECTIVE: To assess the validity of the London handicap scale (LHS) using a simple unweighted scoring system compared with traditional weighted scoring METHODS: 323 patients admitted to hospital with acute stroke were followed up by interview 6 months after their stroke as part of a trial looking at the impact of a family support organiser. Outcome measures included the six item LHS, the Dartmouth COOP charts, the Frenchay activities index, the Barthel index, and the hospital anxiety and depression scale. Patients' handicap score was calculated both using the standard procedure (with weighting) for the LHS, and using a simple summation procedure without weighting (U-LHS). Construct validity of both LHS and U-LHS was assessed by testing their correlations with the other outcome measures. RESULTS: Cronbach's alpha for the LHS was 0.83. The U-LHS was highly correlated with the LHS (r=0.98). Correlation of U-LHS with the other outcome measures gave very similar results to correlation of LHS with these measures. CONCLUSION: Simple summation scoring of the LHS does not lead to any change in the measurement properties of the instrument compared with standard weighted scoring. Unweighted scores are easier to calculate and interpret, so it is recommended that these are used.

Disability Evaluation↗
PubMed1998

The impact of an information pack on patients with stroke and their carers: a randomized controlled trial.

OBJECTIVES: To assess the impact of information packs on patients with stroke and their carers, and to pilot some of the methodology for a trial of a Family Support Organiser (FSO). SUBJECTS: Seventy-one patients admitted to Oxford hospitals with acute stroke during February-July 1995, and 49 informal carers of these patients. DESIGN: Randomized controlled trial. Intervention group received an Information pack containing various Stroke Association publications one month after their stroke, or at discharge from hospital, whichever was sooner. Control group received nothing. Follow-up was by interview at the place of residence of the patients six months after their stroke. MEASURES: Outcome measures assessed knowledge about stroke; satisfaction with information received; patient behaviour in terms of access to community services and benefits; and health status and quality of life. RESULTS: Patients and carers in the intervention group tended to know more about stroke, but these differences were not significant once adjusted for age. Patients in the intervention group (but not carers) tended to be more satisfied with the information that they had received, but the differences were not significant. There were no differences with regard to any aspects of quality of life in patients in the intervention group, though carers in the intervention group were found to have significantly better mental health (p = 0.04). CONCLUSIONS: While the study was too small to generate firm conclusions, information leaflets may lead to improved knowledge about stroke several months after they have been distributed. This finding is worth following up with larger studies. The stroke knowledge questionnaire that was piloted in this trial seems to be able to detect differences between groups.

Aged↗
PubMed1997

Comparison of postal version of the Frenchay Activities Index with interviewer-administered version for use in people with stroke.

OBJECTIVE: To assess the agreement between postal and interviewer-administered versions of the Frenchay Activities Index (FAI) and to assess the criterion validity of the postal version, using interviewer administration as a gold standard. DESIGN: Comparison of responses to FAI administered by post and then by interview (median delay 10 days). SUBJECTS: Forty-eight Oxfordshire residents admitted to hospital with acute stroke between 1 August 1994 and 31 January 1995 and discharged alive within six months of their stroke. RESULTS: The limits of agreement of the total FAI score are from -5.4 to 7.2. The kappa statistic for each of the 15 individual items that make up the FAI ranged from 0.35 to 1. For nine items, agreement was moderate or fair, and for six items, agreement was good or very good. The mean difference between the overall scores was 0.9 (95% confidence interval: -0.1 to 1.9). The correlation between the overall scores was 0.94 (Spearman's rank correlation coefficient). CONCLUSION: The postal version of the FAI is a satisfactory alternative to direct administration, but poor agreement in scores for individual patients emphasizes that the two approaches should not be used sequentially to monitor individual patients.

Activities of Daily Living↗