Dissertations / Theses: 'Cerebrovascular disease – Patients – Care'

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郭穎怡 and Wing-yee Eunice Kwok. "Early supported discharge program for stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720883.

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Vlasic, John P. II. "A research study on emotional adjustment of a spouse following stroke." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1169.

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This research project focuses on age as a predictor in the emotional adjustment of a spouse following his/her partner's stroke. The medical records of 80 stroke cases were reviewed at Kaiser Permanente Medical Center, Fontana, California. Patients and spouses were examined in two age groupings, age 55 and below, and ages 56 and above. Study of these two age groups afforded the most meaningful division to study spouse adjustment.

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Cheung, Yuk-fai, and 張煜暉. "Clinical and health-related quality of life evaluation of acute strokeunit care versus conventional medical care for minor stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48422800.

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The efficacy of stroke units has been extensively investigated in clinical trials. However, little information is available to the health care providers and policy makers on the benefits of stroke unit care in Hong Kong. The quality of life of our local stroke patients is largely unknown. The objective of this study was to compare the 2-month outcomes after stroke admitted to either a stroke unit or a non-stroke unit. Outcomes included mortality, dependency, institutional care and quality of life. This was a prospective observational study conducted in a regional, tertiary hospital in Hong Kong. Baseline demographic and clinical data were collected from the subjects. The 36-Item Short-Form health survey (SF-36) questionnaire was administered to them. Follow up assessment at two months were made for mortality, dependency, institutionalisation, length of hospital stay and SF-36. Eligible subjects were Cantonese-speaking Chinese aged 18 years or over. They should provide written informed consent, and verbally and cognitively competent in completing the SF-36 questionnaire 162 patients with acute stroke were included in the analysis. 106 patients were solely managed in the stroke unit. 41 patients were managed in other wards (as the control group). There were no statistically significant differences found between the two groups for death alone, death or dependency, and death or institutionalisation. Multivariate logistic regression analyses showed similar findings. Mean lengths of acute and total hospital stay were similar between the two groups. Quality of life was impaired during the acute phase of stroke as reflected by low Physical Functioning (PF) and Social Functioning (SF) dimensions of the SF-36. At two months, significant improvement was observed in five out of eight dimensions of the SF-36 as well as its two summary scores, Physical Component Summary (PCS) and Mental Component Summary (MCS). There were several limitations in our study, namely small number of patients, minor stroke severity and tertiary hospital setting. In conclusion, no significant differences in the clinical outcomes were found between the stroke unit group and the control group. These findings were inconclusive in view of limitations in this study. Stroke affected quality of life. Future researches with larger sample size are warranted.
published_or_final_version
Public Health
Master
Master of Public Health

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陳淑玲 and Shuk-ling Chan. "Development, implementation and evaluation of a structural stroke education program for informal caregivers of stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720251.

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Jones, Craig L. "Neuropsychological symptomatology associated with right and left hemisphere cerebral vascular accidents within an acute care rehabilitation setting." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/862284.

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The present study investigated the extent to which right and left hemisphere stroke patients, within an acute care rehabilitation unit, differ in neuropsychological symptomatology as reported on a self-report instrument.The subjects were 90 patients admitted to an acute care rehabilitation unit within a midwestern hospital. Two groups of 30 were obtained on the basis of stroke location, either right or left hemisphere. In addition, a group of 30 orthopedic patients were selected to serve as a comparison group.Data was collected using the Neuropsychological Symptom Inventory (Rattan, Dean & Rattan, 1989). A discriminant analysis revealed two discriminant functions which were used to classify group membership. Slightly more than 86% of both left hemisphere stroke patients and orthopedic patients were correctly classified. However, only 46% of right hemisphere stroke patients were accurately predicted. The results clearly support the ability to differentiate the groups and suggest a homogeneous character of the left hemisphere stroke and orthopedic groups. The right hemisphere group appears heterogeneous in make-up. Further statistical analysis revealed no significant difference (a<.05) between stroke groups when examining a factor related to emotional/depression symptoms. However, when stroke patients were compared to orthopedic patients on this factor, a high degree of significance was revealed (p<.001).These results suggest that right hemisphere patients cannot be treated as if they make up a single disorder group within the rehabilitation setting. The use of a self-report measure may prove beneficial with this group is assessing the level of neuropsychological impairment and to make modifications in treatment planning. Additionally, the existence of depression within the stroke group suggest that rehabilitation should focus more on these reactions within the first few weeks post-stroke.
Department of Educational Psychology

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Lam, Lok-tao Otto, and 林樂濤. "A randomized clinical trial of oral health promotion interventions among patients following stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hdl.handle.net/10722/207561.

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OBJECTIVES: The primary objective of this study was to evaluate the effectiveness of of oral health promotion interventions on both clinical oral health, and oral opportunistic pathogens in hospitalized patients following acute stroke. Secondary objectives were to investigate the development of infectious complications, as well as health-related quality of life during the hospitalization period, and to monitor clinical oral health, oral opportunistic pathogens, and health-related quality of life following hospital discharge. METHODS: A total of 102 patients were recruited into a clinical trial conducted among stroke patients in a rehabilitation ward. Patients were randomly assigned either: 1) oral hygiene instruction 2) oral hygiene instruction and chlorhexidine mouthrinse or 3) oral hygiene instruction, chlorhexidine mouthrinse, and assisted brushing. Dental plaque, gingival bleeding, oral opportunistic pathogens, health-related quality of life, oral health-related quality of life, and functional status were assessed at baseline and review. The development of infectious complications was also monitored during the clinical trial. Patients completing the clinical trial were assessed at six months following hospital discharge. RESULTS: Eighty-one patients were available for review at the end of the clinical trial. Reductions in dental plaque (PI) scores were significantly greater in the two groups receiving chlorhexidine compared to the group receiving oral hygiene instruction alone (p<0.001). Reductions in gingival bleeding (GBI) scores were three to four-fold greater in groups receiving chlorhexidine. Almost three quarters (72.8%) of patients harbored oral aerobic and facultatively anaerobic Gram-negative bacilli (AGNB) at baseline. Over half of the patients had detectable Staphylococcus aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed between groups (p>0.05). No cases of pneumonia were observed during the course of the clinical trial. Health-related quality of life (p<0.001), oral-health related quality of life (p=0.014), general functional disability (p<0.001), and toothbrushing ability (p=0.001) improved significantly during hospitalization. A total of 52 patients were reviewed six months following hospital discharge. PI scores were significantly higher than those observed at the end of the clinical trial (p<0.001), but were still significantly lower than those documented at baseline (p<0.001). Changes in GBI scores did not reach statistical significance (p>0.05). Percentage frequencies of AGNB (p=0.001), and viable counts of both AGNB (p<0.001) and yeasts (p=0.028) were significantly reduced at six months. No significant gains in life quality or oral functional disability were observed following hospital discharge (p>0.05). CONCLUSIONS: The clinical oral health condition of stroke patients may be safeguarded following acute stroke with the use of chlorhexidine mouthrinse in conjunction with a standard mechanical plaque removal regimen. These interventions are acceptable to the majority of patients, and their administration poses a minimal burden to rehabilitation ward staff. There was, however, no significant difference in the effectiveness of the three different oral health promotion interventions in combating oral opportunistic pathogens. Gains in quality of life and oral functional disability were largely limited to the in-hospital rehabilitation period.
published_or_final_version
Dentistry
Doctoral
Doctor of Philosophy

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Kong, Yin-ying, and 江燕瑩. "Telenursing program for supporting family caregivers of stroke survivors: an evidence-based clinicalguideline." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44623525.

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Biggs, Debbie Lynn. "Health promotion needs of stroke patients accessing community health centres in the metropole region of the Western Cape." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs&rsquo
assessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel ®
. Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants&rsquo
suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants&rsquo
health status and ultimate quality of life.

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Waterfall, A. Christine. "Needs of caregivers of stroke survivors." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1246469.

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Stroke is a medical event that has serious consequences for the survivor, his family, and society. Stroke is the third leading cause of death in the United States, and two-thirds of stroke survivors are permanently disabled with one-half of these survivors considered severely impaired. The economic burden from stroke is estimated to be $30 billion annually in health care costs and lost productivity.This study described the needs of 35 caregivers of stroke survivors within 24 hours of discharge to home from an acute care "safety net" teaching hospital in Indiana and how well those needs were met. Two subscales, (a) the Need for Information and (b) Patient Care Needs, of the Home Caregiver Need Survey were used. The theoretical framework for this study was the Neuman Systems Model.The stroke survivors were over 50 years old (77.1 %), half were African-American and half were Caucasian, and about a quarter were minimally impaired (25.8%) and less than a quarter were very impaired (22.9%) cognitively and/or physically upon discharge to home. Their caregivers were their children (48.6%) or spouses (28.6%), half of whom worked full-time outside the home. Most (85.7%) caregivers were female, in good health, and with no experience (81.8%) in caring for patients at home.
School of Nursing

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Kleineibst, Lynn Jill. "The effectiveness of a caregiver support programme to address the needs of primary caregivers of stroke patients in a low socio economic community." Thesis, Link to the online version, 2007. http://hdl.handle.net/10019/432.

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Rhoda, Anthea. "The rehabilitation of stroke patients at community health centres in the Western Cape." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5654_1318838292.

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The rehabilitation of stroke patients can occur at different settings. These include in-patient settings, such as stroke units or general rehabilitation wards and out-patient settings, such as out-patient departments attached to hospitals, day hospital departments and the patientsâ home. In South-Africa, day hospitals have been upgraded and are now referred to as Community Health Centres which provide comprehensive health services to the population. In the Western Cape these centres are faced with the rehabilitation of stroke patients who have been discharged early from hospital during the acute stage or who have never been admitted to hospitals. To date there is a lack of best practice guidelines and formal evaluations in terms of efficacy and effectiveness of rehabilitation at these centres. The aim of the study was therefore to investigate the rehabilitation of stroke patients at Community Health Centres in the Metropole Region of the Western Cape. The structure, process and outcomes (SPO) model was used as a conceptual framework in this study.

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Scannell, Alice Updike. "The Longterm Psychosocial Impacts of Caregiving on the Caregivers of Persons with Stroke." PDXScholar, 1989. https://pdxscholar.library.pdx.edu/open_access_etds/1312.

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This study is a Time 4 (T4) follow-up interview of ninety-three caregivers of persons who experienced a first stroke between 2 to 4 years (mean = 36 months) prior to the T4 interview. The first wave of data collection occurred within two months after the stroke. The second and third waves occurred six and twelve months, respectively, after the first interview. The caregivers were identified by the person with stroke as being the person closest to him/her who would be responsible for care after the stroke. Data were gathered at all four interviews using reliable and valid measures for depressive symptomatology (CES-D; Radloff, 1977), psychological well-being (IPWB; Berkman, 1971), and caregiver burden (Zarit, 1980). The contribution of social support to caregiver well-being was also investigated. Additional areas of investigation at T4 included coping strategies (F-Copes; McCubbin, Larsen, and Olson, 1981), caregiver adjustment, and the respondents' perception of themselves as "caregivers". The mean scores of depressive symptomatology, perceived burden, negative well-being, and positive well-being did not change significantly over the four points in time. However, the percentage of the sample having CES-D levels of 16 and above (indicating potential diagnosis of clinical depression) decreased by ten percent between T1 and T4. About ten percent of the respondents who were at risk for clinical depression at T4 reported high levels of depressive symptoms at all four interviews. Respondents who specifically thought of themselves as "caregivers" (sixty-two percent) were significantly more likely to report high levels of depressive symptoms, to experience high levels of strain and caregiver burden, and to be caring for persons who were more severely impaired by the stroke than those who did not. Caregiver characteristics contributed more to the variance in depressive symptoms and psychological well-being than did characteristics of the stroke. However, depressive symptomatology and perceived burden were significantly associated with both the functional capacity of the person with stroke and with an index of stroke severity comprised of communication impairments and negative personality/behavior changes since the stroke. The findings from this study have implications for stroke management programs, caregiver intervention planning, and health care policy.

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Tam, Lai-yin Ann, and 譚麗賢. "Study of the strain and needs of adult children caregivers of elderly stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31250270.

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Wong, Shui Wai, and 黃瑞威. "The living arrangements of discharged stroke patients from H.K. Buddhist Hospital." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1988. http://hub.hku.hk/bib/B31248263.

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Zhu, Haiwei, and 竺海瑋. "Oral health-related quality of life after stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B37922567.

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Hassan, Soelaylah A. M. "The impact of stroke on the primary caregiver." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/3387.

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MPhil (Rehabilitation)
Thesis (MPhil (Interdisciplinary Health Sciences))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: A stroke comes suddenly and has a devastating effect on the lives of the patient and the caregiver. It is disabling and often leaves the patient dependent on care. Providing this care can put tremendous physical, emotional, social and financial demands on the caregiver. The purpose of the study is to determine the impact of caregiving on the primary caregivers of patients who suffered a stroke and were admitted to the Western Cape Rehabilitation Centre (WCRC), for intensive rehabilitation during 2006. This is a descriptive study that utilised both quantitative and qualitative methods of data collection. Quantitative data were collected through two data coding forms, one for caregivers and one for patients, the Bartel Index, the Caregiver Strain Index (CSI) and the Satisfaction With Life Scale (SWLS). Qualitative data were collected through indepth interviews with caregivers. Fifty-seven caregivers participated in the study. According to CSI findings 58% of caregivers were under levels of strain high enough to require support and intervention. The SWLS indicated that the life areas most adversely affected were employment and self and social life. Loss of employment by the caregiver (p = 0.04) and financial difficulties (p = 0.06), cognitive and perceptual problems (p = 0.01), personality changes (p = 0.01), level of physical dependency of patient (0.0012) and nervous strain experienced by the caregiver (0.01) were found to significantly impact on caregiver strain. Caregivers perceived their caregiving duties as overwhelming and a great strain. This was aggravated in some instances by poor health care service delivery at the time of the stroke, no or inadequate explanations on stroke, poor or no training of caregivers, no home visits and a lack of follow-up services in the community. They experienced the period just after discharge as especially challenging and required support, assistance and guidance at that time. Caregivers identified a need for community rehabilitation facilities, adult day care centres, outpatient rehabilitation services, home-based nursing care and caregiver support groups in the community.
AFRIKAANSE OPSOMMING: ’n Beroerte gebeur skielik en sonder enige waarskuwing met ’n vernietigende uitwerking op die lewens van die pasiënt asook die versorger. Dit veroorsaak gestremdheid en laat dikwels die pasiënt afhanklik van sorg. Die voorsiening van hierdie sorg kan erge fisiese, emosionele, sosiale en finansiele eise aan die versorger stel. Die doel van die navorsing is om die impak van versorging op die primêre versorger van beroerte pasiënte, wat gedurende 2006 intensiewe rehabilitasie by WKRS ontvang het, te ondersoek. Dit is ’n beskrywende studie wat gebruik gemaak het van beide kwantitatiewe en kwalitatiewe metodes om data in te samel. Kwantitatiewe data was verkry deur twee datakoderingsvorms, een vir pasiente en een vir versorgers, die Bartel Index, die Caregiver Strain Index (CSI) en die Satisfaction With Life Scale (SWLS). In diepte onderhoude was gevoer met versorgers om kwalitatiewe data te verkry. Sewe en vygtig versorgers het aan die studie deelgeneem. Bevindinge van die CSI dui daarop dat 58% van versorgers hoë vlakke van spanning ervaar en ondersteuning sowel as intervensie benodig. Volgens die SWLS was die areas wat die ernstigste be-invloed was werk en eie en sosiale lewe. Die volgende areas het volgens resulate ’n statisties beduidende impak op die spanning wat versorgers ervaar het gehad: finansiële spanning en verlies van werk (p = 0.04), in gevalle waar pasiente persoonlikheids veranderinge ondergaan het (p = 0.01) of kognitiewe en perseptuale skade oorgehou het (p = 0.01) na die beroerte en die emosionele impak van versorging (p = 0.01). Versorgers het hulle versorgings take as oorweldigend en as ’n bron van groot spanning gesien. Dit is in sommige gevalle vererger deur swak ondersteuning van gesondheidssorgdienste direk na die beroerte, geen of swak verduidelikings oor wat ’n beroerte is, geen of swak opleiding aan versorgers, geen tuisbesoeke en ’n tekort aan opvolg dienste in die gemeenskap. Die tydperk direk na ontslag uit die rehabilitasie sentrum was besonder uitdagend en hulle het ondersteuning, hulp en leiding nodig in daardie tyd. Swak ondersteuning en ’n tekort aan of afwesigheid van hulpbronne in die gemeenskap het die situasie vererger. Versorgers het ’n behoefte aan gemeensskapsrehabilitasie fasiliteite, volwasse dagsorg sentrums, buite patiënte rehabilitasie dienste, tuis verpleegsorg en ondersteuningsgroepe uitgespreek.

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Botha, J. H. "The refinement of a booklet on stroke care at home." Thesis, Stellenbosch : University of Stellenbosch, 2008. http://hdl.handle.net/10019.1/1903.

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Thesis (MScMedSc (Rehabilitation))--University of Stellenbosch, 2008.
Stroke is the second commonest cause of mortality worldwide and remains a leading cause of adult physical disability. It is estimated that sixty percent of South African stroke survivors require assistance with at least one activity of daily living. This burden is predominantly on the shoulders of mostly untrained caregivers. The process of enabling caregivers to make choices conducive to their own health as well as the health of the stroke survivors is multidimensional. One of the cornerstones of this process is the provision of information. In 1995, the Centre for Rehabilitation Studies of the University of Stellenbosch started to develop a training package for stroke care at home. The training takes the form of an interactive workshop and a booklet with practical information. The aim of this study was to refine and pilot this booklet for implementation with the training. The study found that existing guidelines to evaluate the appropriateness of written material for developing communities (measured by Hugo’s grading model), were inadequate. Consequently, a new checklist, based on twenty existing checklists, was compiled. This list, as well as the Suitability Assessment of Material (SAM), was used to evaluate the booklet and make recommendations for a pre-pilot refinement. Even though this checklist has not been validated, it revealed similar results to the SAM when applied to the booklet. After cosultation with the authors, improvements were effected to the booklet The booklet was tested with four samples of the target audience. The functional literacy of the participants was determined using a standardised literacy test. A fifth sample completed a questionnaire on their preference between the pre- and postrefined booklet. Experts in the field of rehabilitation and graphic design also commented on the booklet. This study confirmed the need of stroke survivors and their caregivers for written health information. The refined booklet was found to be an appropriate tool to address the needs of the target audience. The participants perceived the booklet as useful and comprehensible and the readability level was shown to correspond with the tested literacy level of the samples. However, there is a need for printed material on topics related to stroke not currently covered in the booklet, e.g. spasticity. This study showed that the checklist could be used to tailor written health information that is preferred by the target audience. It confirmed that the testing of printed material with stakeholders could expose additional gaps after applying the checklist. Recommendations for further improvements were made based on the comments of the participants. It is foreseen that the new checklist could be a valuable tool for developing future written health material. Finally, it is recommended that an interdisciplinary team that includes a graphic designer be involvement from the planning stages.

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Cheng, So-fong Nancy, and 鄭素芳. "The use of Minuchin's structural approach in an exploratory studyof the impact of stroke on families." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31247465.

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Hoffmann, Tammy Coral. "Development and evaluation of a computer-generated individualised written education package for patients following stroke and their carers /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18924.pdf.

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Nelson, Merlisa Claudia. "Ultrasound evaluation of the extracranial cerebrospinal venous system and carotid arteries in patients with multiple sclerosis." Thesis, Cape Peninsula University of Technology, 2013. http://hdl.handle.net/20.500.11838/1565.

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Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Radiography in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology Supervisor: Ms. Ferial Isaacs Co-supervisor: Prof. Susan J. Van Rensburg Bellville September 2013
Multiple Sclerosis (MS) is characterised by demyelination within the central nervous system (CNS), which may result in neurological disabilities over time, causing considerable hardship to patients and their families, in addition to being costly to treat. Recent studies have linked MS to impaired cerebral blood flow, called chronic cerebrospinal venous insufficiency (CCSVI). Anecdotal evidence has suggested that surgical correction thereof results in improvement of symptoms experienced by MS patients. To my knowledge, no information is available in the literature on carotid artery disease in MS. The USA National MS Society has therefore called for more research to be done in this area. This cross-sectional observational sub-study will determine, by ultrasound (B-Mode, Colour and Pulsed-wave Doppler), the prevalence of chronic venous insufficiency (CCSVI) and carotid artery disease in the selected sample of MS patients within the region of the Western Cape, South Africa. Biochemical data; lifestyle factors such as physical activity and smoking; and nutritional status of MS patients were determined from the main study entitled: “The development of a comprehensive gene-based, pathology supported intervention program for improved quality of life in patients diagnosed with multiple sclerosis” (Division of Chemical Pathology, NHLS, Tygerberg Hospital, and University of Stellenbosch). Twenty-nine (29) patients were aged between 28-64years and they suffered from MS for 0.83-27years. A larger proximal and mid cross-sectional diameter (CSD) of the right IJV compared to the left (differences significant, P= 0.026 and P=0.023) was demonstrated. Increased intima media thickness (IMT) was present in 13.33% of the non-smoking MS group and 20% in the smoking MS group. IJV reflux was evident in 13.33% of the MS group. A significant reduction of cross-sectional diameters of the IJV’s was evident in smoking MS patients; suggesting that smoking is not only a risk factor for atherosclerotic disease but could also be related to narrowing of the major neck veins. This study also supports findings of other studies viz that there’s no significant correlation between extracranial venous abnormalities and MS. Early carotid artery disease was noted in smoking and non-smoking MS patients, however the findings were non-significant.

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Ellis, Graham. "Stroke liaison workers for patients and carers." Thesis, Connect to e-thesis, 2008. http://theses.gla.ac.uk/288/.

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Thesis (MD.) - University of Glasgow, 2007.
MD. thesis submitted to the Division of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, 2007. Includes bibliographical references. Print version also available.

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Kwok, Wing-yee Eunice. "Early supported discharge program for stroke patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720883.

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Willats, Lisa. "Improved quantification of perfusion in patients with cerebrovascular disease." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1445148/.

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In recent years measurements of cerebral perfusion using bolus-tracking MRI have become common clinical practice in the diagnosis and management of patients with stroke and cerebrovascular disease. An active area of research is the development of methods to identify brain tissue that is at risk of irreversible damage, but amenable to salvage using reperfusion treatments, such as thrombolysis. However, the specificity and sensitivity of these methods are limited by the inaccuracies in the perfusion data. Accurate measurements of perfusion are difficult to obtain, especially in patients with cerebrovascular diseases. In particular, if the bolus of MR contrast is delayed and/or dispersed due to cerebral arterial abnormalities, perfusion is likely to be underestimated using the standard analysis techniques. The potential for such underestimation is often overlooked when using the perfusion maps to assess stroke patients. Since thrombolysis can increase the risk of haemorrhage, a misidentification of 'at-risk' tissue has potentially dangerous clinical implications. This thesis presents several methodologies which aim to improve the accuracy and interpretation of the analysed bolus-tracking data. Two novel data analysis techniques are proposed, which enable the identification of brain regions where delay and dispersion of the bolus are likely to bias the perfusion measurements. In this way true hypoperfusion can be distinguished from erroneously low perfusion estimates. The size of the perfusion measurement errors are investigated in vivo, and a parameterised characterisation of the bolus delay and dispersion is obtained. Such information is valuable for the interpretation of in vivo data, and for further investigation into the effects of abnormal vasculature on perfusion estimates. Finally, methodology is presented to minimise the perfusion measurement errors prevalent in patients with cerebrovascular diseases. The in vivo application of this method highlights the dangers of interpreting perfusion values independently of the bolus delay and dispersion.

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Vattanasilp, Wantana. "The contribution of neural and peripheral factors to muscle stiffness and function following stroke." Thesis, The University of Sydney, 1998. https://hdl.handle.net/2123/26242.

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The aim of these studies was to investigate the contributions of neural and peripheral factors to the increased resistance to movement and loss of function commonly observed following stroke. Three studies were undertaken to investigate the stiffness of the calf muscles in stroke subjects. Under relaxed conditions, neural factors such as spasticity and peripheral factors such as contracture and thixotropy were investigated. Under active conditions, the contribution of the tonic stretch reﬂex to functional movement, in this case walking, was investigated. These ﬁndings were compared to results retained from neurologically-normal subjects. The clinical measurements of spasticity (Ashworth Scale and tendon jerk) were collected and the laboratory measurement (tonic stretch reﬂex) was measured in all studies. Clinical measurements of spasticity were performed to describe the stroke subjects clinically, whereas the laboratory measurement, ie, the measurement of the tonic stretch reﬂex recording EMG during sinusoidal stretching, was performed to provide a quantitative benchmark of spasticity in the gastrocnemius muscle. Measurement of the tonic stretch reﬂex was chosen because EMG can differentiate the neural and the peripheral contributions. Under relaxed conditions, it was found that most stroke subjects exhibited resting tonic stretch reﬂexes, indicating the presence of spasticity. Stroke subjects also exhibited a thixotropic response which was within the range of normal responses. Some stroke subjects displayed muscle contracture. When the contributions of these various factors to stiffness were examined, contracture appeared to make the most significant contribution to the increased resistance to movement. Under active conditions, the contribution of spasticity to walking dysfunction following stroke was investigated in a group of ambulant stroke subjects. The tonic stretch reﬂex was investigated under active conditions which mimicked the movement of the ankle joint during walking. Stroke subjects exhibited a smaller action tonic stretch reﬂex compared with normal subjects, and this ﬁnding was not statistically different. It was suggested that rather than exhibiting an ‘out of control’ tonic stretch reﬂex, stroke subjects had an impaired modulation of the tonic stretch reﬂex. Also, the action tonic stretch reﬂex of stroke subjects did not contribute as much as that of normal subjects to the resistance of calf muscles under active conditions. Therefore, it is suggested that an abnormal tonic stretch reﬂex does not routinely contribute to walking dysfunction following stroke. Furthermore, when the modulation of the tonic stretch reﬂex was measured at pre-ambulatory and ambulatory stages after early stroke, it was found that an improvement in function of the ankle joint was not accompanied by an ability to modulate the tonic stretch reﬂex in the gastrocnemius muscle. Finally, a relation between the clinical and laboratory measurements of spasticity was found only for the tests of resistance to movement, but not for the tests of reﬂex activity. These ﬁndings suggested that clinical tests cannot adequately quantify spasticity, and that the resistance felt during passive movement cannot be differentiated using a clinical grading test such as the Ashworth Scale. These studies add to the growing body of evidence that spasticity is not the major problem interfering with functional tasks after stroke. Therefore, it is not important to routinely reduce spasticity for the purpose of improvement in function. However, the need to prevent and/or minimise muscle contracture is essential in order to avoid the increase in passive stiffness which accompanies the contracture.

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Rau, Marie Therese. "Elderly stroke patients and their partners: a longitudinal study of social support and well-being changes associated with a disabling stroke." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/478.

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This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.

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Cotter, Paul Eoin. "Cardiac parameters in young patients with cryptogenic stroke." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648802.

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Sit, Bik-yan Sonia. "Cognitive function in Chinese stroke patients /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31595923.

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Wan, Wai-kuen Christina, and 尹慧娟. "An exploratory design of an empowerment group for the strokesurvivors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31978228.

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Tsang, Sai-ling. "Community readjustment of discharged stroke patients : an exploratory study /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322490.

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張晶凝 and Ching-ying Crystal Cheung. "Facial emotion recognition after subcortical cerebrovascular diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31224155.

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馮美玲 and Mei-ling Fung. "Stroke rehabilitation: predicting LOS and discharge placement." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970515.

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Tam, Lai-yin Ann. "Study of the strain and needs of adult children caregivers of elderly stroke patients /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470265.

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Luk, Wai-ha Veronica. "Evidence-based DVT prophylactic guideline for stroke and neurosurgical patients." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251419.

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Fung, Shuk-man Wendy. "A study of medical social services and stroke patients : an application of the unitary approach /." [Hong Kong : University of Hong Kong], 1993. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13418014.

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Li, Sijian, and 李斯儉. "Evaluating the effectiveness of a stroke education programme in Wuhan City of China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31221397.

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36

Man, Lai-mei, and 文麗媚. "An exploratory study for the health seeking pattern of stroke survivors on alternative medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31978617.

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37

Fryer, Bradley James. "The relationship between task complexity and cerebral oxygenation in stroke patients." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80371.

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Thesis (MSportSc)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: There are a growing number of men and women world-wide who are suffering strokes due to poor lifestyle-related habits. While there is evidence of the differences in cerebral haemodynamics between stroke patients and both elderly and young healthy individuals, limited evidence has examined the effect of rehabilitation on cerebral haemodynamics. Furthermore, most studies have examined changes in cerebral haemodynamics during cognitive and functional tasks in isolation, with no literature published on them simultaneously. The primary aim of this study was to examine whether differences in cerebral haemodynamics exist between stroke patients and healthy elderly individuals while performing a simple and complex cognitive task. Thirty two men and women (age 75 ± 8 years) volunteered to participate in the study and were split into an experimental (n = 14) group consisting of stroke patients and a control (n = 18) group consisting of healthy individuals. Each participant was required to attend one testing session where measurements of oxyhaemoglobin (O2Hb), deoxy-haemoglobin (HHb), tissue oxygenation index (TOI) and total haemoglobin index (THI) were obtained. Measurements were obtained with the participants at rest, while performing the Mini Mental State Exam (MMSE) and the modified Stroop Task as cognitive tests, and the Timed Up-and-Go (TuG) and six minute walk test (6MWT) or Toe Taps (TT) as the functional tests. Furthermore, the outcome scores of the various tests were also recorded. Change in O2Hb levels were lower in the experimental group than in the control group, especially in the left prefrontal cortex (LPFC) while HHb values were higher in the right prefrontal cortex (RPFC) (p > 0.05). There were almost no differences in TOI between the two groups in either the LPFC or RPFC, however, statistically significant differences were seen in THI in the RPFC during the MMSE (p = 0.03), rest period 2 (p = 0.03), the first modified Stroop Task (p = 0.04), as well as the TuG (p = 0.02). Furthermore, significant differences were seen between the two groups with respect to the time taken to complete the TuG, with the experimental group completing it much faster (p = 0.04). The experimental group participants who had received regular rehabilitation performed consistently better across most of the testing phases, with a number of practically significant findings. The results show that definite differences exist between stroke patients and healthy elderly individuals when performing a simple and complex task. The positive effect of low intensity exercise on task performance was clearly seen in both groups, and holds a great deal of practical significance for the development of exercise programmes for healthy individuals, as well as stroke patients. Furthermore, rehabilitation following a stroke has obvious benefits as shown by the positive results of the current study, however, limited research exists to validate these findings, highlighting the need for further research in this area.
AFRIKAANSE OPSOMMING: Daar is ŉ wêreld wye toename in die aantal mans en dames wat beroertes ondervind as gevolg van swak lewenstyl-verwante gewoontes. Alhoewel baie navorsing beskikbaar is oor die verskille in serebrale hemodinamika tussen beroerte pasiënte en bejaardes, asook jong gesonde individue, is daar ŉ beperkte aantal studies oor die effek van rehabilitasie op serebrale hemodinamika. Meeste van hierdie studies het die veranderinge in serebrale hemodinamika tydens kognitiewe of funksionele take in isolasie ondersoek, met geen literatuur waar die effek van albei gesamentlik gemeet word nie. Die hoofdoel van hierdie studie was om die verskille in serebrale hemodinamika tussen beroerte pasiënte en gesonde bejaardes, tydens die uitvoering van ŉ eenvoudige en komplekse kognitiewe taak, te ondersoek. Twee-en-dertig mans en vroue (ouderdom 75 ± 8 jaar) het aan die studie deelgeneem. Die eksperimentele groep (n = 14) het bestaan uit die beroerte pasïente en die kontrole groep (n = 18) was gesonde bejaardes. Elke deelnemer het een toets sessie bygewoon waartydens oksihemoglobien (O2Hb), deoksihemoglobien (HHb), weefsel oksigenasie indeks (TOI) en totale hemoglobien indeks (THI) gemeet is. Metings is tydens rus geneem, asook tydens die kognitiewe toetse, die “Mini Mental State Exam” (MMSE) en die gewysigde Stroop taak gemeet, en die funksionele toetse, naamlik die “Timed Up-and-Go” (TuG) en die ses minute loop toets (6MWT) of “Toe Taps” (TT). Die eksperimentele groep se O2Hb was laer as die kontrole groep, veral in die linker voor frontale korteks (LPFC), en die eksperimentele groep se HHb waardes was hoër in die regter voor frontale korteks (RPFC) (p > 0.05). Daar was geen statisties betekenisvolle verskille in TOI tussen die twee groepe nie, maar wel in die THI in die RPFC tydens die MMSE (p = 0.03), rusperiode twee (p = 0.03), die eerste gewysigde Stroop Taak (p = 0.04) en die TuG toets (p = 0.02). Die kontrole groep was statisties betekenisvol vinniger as die eksperimentele groep in die TuG toets (p = 0.04). Deelnemers in die eksperimentele groep wat gereelde rehabilitasie ontvang het, het konsekwent beter gevaar tydens die toets sessie, en ŉ aantal prakties betekenisvolle verskille is in sekere veranderlikes gevind. Die resultate dui aan dat daar wel ŉ verskil in serebrale hemodinamika bestaan tussen beroerte pasiënte en gesonde bejaardes terwyl hulle eenvoudige en komplekse take verrig. Die positiewe effek van lae intensiteit oefening op prestasie was duidelike sigbaar van beide groepe. Hierdie resultate is prakties betekenisvol as dit kom by die ontwikkeling van oefenprogramme vir gesonde individue asook beroerte pasiënte. Rehabilitasie na ŉ beroerte hou ooglopende voordele in soos aangedui deur die positiewe bevindinge van die huidige studie, hoewel daar beperkte navorsing beskikbaar is om hierdie bevindinge te staaf. Daar is dus ŉ behoefte vir verdere navorsing in hierdie gebied.

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38

Chang, Chia-yu Stephanie Celeste. "Does social-demographic information predict residential outcomes in elderly stroke rehabilitation patients in Hong Kong?" Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971520.

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Mok, Siu-wai Kanness. "Use of elderly mobility scale as a functional predictor in stroke patients during inpatient rehabilitation." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972056.

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40

Urimubenshi, Gerard. "Profile of and challenges experienced by stroke patients admitted to Ruhengeri Hospital in Rwanda." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3179_1273708790.

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Stroke is the world&rsquo
s third highest cause of death and a major cause of disability. In order to define optimal management for stroke, reliable data are needed. Although Ruhengeri Hospital in Rwanda receives many stroke patients, no in-depth study has been carried out on stroke patients admitted at the hospital. This study, therefore, identified the profile of stroke patients admitted at Ruhengeri Hospital in Rwanda and explored the challenges that they experienced. A concurrent mixed model design was used to collect data. With a data gathering instrument which was developed by the researcher, a quantitative retrospective approach was used to review existing patients&rsquo
records to collect information related to demographic characteristics, documented clinical features and risk factors for stroke, stroke onset-admission interval, length of hospital stay and the process of hysiotherapy for stroke patients. In-depth face-toface interviews were also used to collect data regarding the challenges experienced by stroke patients. The sample for the quantitative phase consisted of medical records of stroke patients admitted at Ruhengeri Hospital from January 1st, 2005 up to December 31st, 2008. In the qualitative phase, a purposive sample of 10 participants was selected.

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41

Chan, Shuk-ling. "Development, implementation and evaluation of a structural stroke education program for informal caregivers of stroke patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720251.

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42

Tsang, Yuen. "The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B3197224X.

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43

Cooper, Natalie R., and University of Lethbridge Faculty of Arts and Science. "Reduced peri-infarct dysfunction with pre-stroke exercise : molecular and physiological correlates." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2003, 2003. http://hdl.handle.net/10133/215.

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The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct. Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the amount of peri-infarct movement represnetations and initiates vascular changes within motor cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke may enhance functional and behavioural recovery.
140 leaves : ill. (some col.) ; 29 cm.

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Davison, Andrew Charles. "Development of a smart knee brace for early gait rehabilitation of stroke patients /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 68 p, 2007. http://proquest.umi.com/pqdweb?did=1251900481&sid=2&Fmt=2&clientId=8331&RQT=309&VName=PQD.

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Thesis (M.S.M.E.)--University of Delaware, 2006
Principal faculty advisors: Sun, Jian-Qiao, Dept. of Mechanical Engineering; Katherine Rudolph, Dept. of Physical Therapy. Includes bibliographical references.

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45

Wang, Li, and 王立. "Agreement between stroke patients' and proxy assessments of health-related quality of life." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48426003.

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Background: Stroke has become the second most cause of death and leading cause of disability worldwide. Patients-reported health related quality of life measures are often used in evaluating stroke outcomes. However, many stroke patients can not participate in the outcome assessments due to severe disability or aphasia or cognitive impairment. In this case, proxy respondents can be used as secondary information sources. The principle thing needs to be paid attention to in using proxy’s assessments is the reliability or agreement between patient and proxy. Western studies have shown that the agreement between patient and proxy was moderate to substantial. However, such studies are limited in China. Simply applying overseas research outcomes on local population is not appropriate. Therefore, we conducted this study to find out the agreement between stroke patients and proxy assessments about quality of life in China. Methods: 100 patient-proxy pairs were enrolled in our study. Our study was a hospital-based study. The included patients were 3 months after stroke, and patients with more than moderate aphasia or cognitive impairment were excluded. Proxies were people who knew the patients > 1 year, contacted with the patients ≥ 3 days per week, were responsible for ≥ 2 caregiving tasks, and ≥ 18 years. The Chinese version of Stroke-specific quality of life scale (SS-QoL) was used to assess the stroke patients’ QoL, and proxy version of SS-QoL was used in proxies’ evaluation. The evaluation process of patient and proxy was separately and concurrently. Method of self-reported combined with interview-administered was adopted. Paired t tests or Wilcoxon signed ranks tests were performed to test the systematic differences between patient and proxy. The agreement level between patient and proxy assessments on stroke QoL was estimated by Intraclass correlation coefficient (ICC). Multiple linear regression was performed to find out factors affecting the patient-proxy agreement. Results: Patients were older (61 versus 48 years) and more often male (63% versus 44%). Mean systematic differences ranged from 0.03 to 0.44. Only 3 domains of differences were statistical significant (Language, Personality, and Work/productivity). The strength of agreement between patient and proxy reporting ranged from fair to perfect (ICC: 0.31 to 0.87). Better agreement was observed in more objective domains while worse agreement was reported in more subjective domains. Proxy education was tested to be a significant predictor of the overall patient-proxy score difference, which indicated that higher proxy education level was associated with greater agreement. It was shown that higher overall patient-reported or proxy-reported SS-QoL score was associated with less stroke impairments. Factors of stroke impairments, patient/proxy education level, patient/proxy gender, and stroke type separately have significant impacts on the agreement between patient and proxy in different domains of QoL. Conclusion: Our findings indicate that proxies may provide reliable information for assessments about stroke patients’ quality of life in China. And the outcomes are more appropriate for mind to moderate stroke patients. For further studies, the reliability of proxy information about severe stroke patients should be paid attention to. Research about changes of agreement between patient and proxy along with the disease development process would be focused on.
published_or_final_version
Public Health
Master
Master of Public Health

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Mo, Wing-yan Anita, and 巫詠欣. "Acute stroke patients age 65 years and older: outcome and predictors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010298.

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Li, Mei-ling, and 李美玲. "Impact of stroke on quality of life and cost." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B46939283.

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Petit, Amanda. "Patient-Provider Communication in Patients with Inflammatory Bowel Disease." Ohio University Honors Tutorial College / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1528924843222824.

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Cheng, So-fong Nancy. "The use of Minuchin's structural approach in an exploratory study of the impact of stroke on families /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322350.

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Duncan, Marie Theresa. "Alzheimer's Disease Caregivers: The Transition from Home Care to Formal Care." PDXScholar, 1992. https://pdxscholar.library.pdx.edu/open_access_etds/3228.

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When family members no longer have the capacity to meet Alzheimer's Disease (AD) caregiving demands at home, a move to a nursing home or other formal care facility becomes the only solution. Recognizing this as a time of transition, three research questions were identified: (1) What do family caregivers to AD individuals experience as they shift their caregiving from home to formal care settings? (2) How does caregiving in formal care differ from caregiving at home? and (3) How do family caregivers perceive the relationships that develop between families and formal care staff? Specific attention was paid to the experiences of spouses and adult children. Using a qualitative approach, two specific bodies of data were investigated. First, transcripts of a series of 30 focus groups with 179 caregivers, and second, ten follow-up interviews were analyzed. Both spouses and adult children overwhelmingly identified physical exhaustion and often emotional exhaustion as the pervasive common experience. After reaching this state, caregivers identified the pivotal nature of events in contributing to placement. These kinds of events turn out to be more like turning points than crises. Caregivers in this study identified five themes that were influential in their decision-making process. In order of their importance to the caregivers, they were: events, the health care system, caregiver-care receiver relationship, support, and options and availability. A male spouse caregiver was likely to cite a turning point event centered on an incontinence problem, while for a female spouse caregiver, it was an AD safety issue. The health care system was usually a negative influence and served to delay the placement decision. Immediately, after placement, family caregivers noted shifts in control, involvement and personal reorganization. Family caregivers frequently noted the development of a caregiving relationship with staff. The individuals whom the family caregivers mentioned most often were the aides. Their bottom line was that staff deliver quality care, which they equated with caring about the resident rather than only taking care of them. The findings from this study have implications for theory development, family caregivers, formal care staff, and health care policy.

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Dissertations / Theses on the topic 'Cerebrovascular disease – Patients – Care'

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