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.
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Presentatie gegeven over de review in Brussel Objectives: In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined.
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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Worldwide, a third of all adults is suffering from feelings of loneliness, with a peak at young adulthood (15-25 years old). Loneliness has serious consequences for mental and physical health and should therefore be urgently addressed. However, existing interventions targeting loneliness mainly focus on older adults [1], and rarely consider the physical living environment, while studies prove that the physical environment (e.g. amenities, green, walkability, liveliness) has a significant impact on loneliness. Collaboration between the psychosocial and physical domains is key, to gain insight into the mechanisms and pathways linking characteristics of the physical living environment and loneliness among young adults and which spatial interventions are effective in managing loneliness. The main research questions are thus: how are physical environment and loneliness related, and which interventions should be implemented? The I BELONG proposal aims to build a European consortium that will address these questions. WP1 encompasses collaboration and networking activities that will form the basis for future collaboration, for instance a European research grant application. WP2 will provide insight in the pathways linking spatial attributes and loneliness. This will be achieved by doing a systematic literature review, a photovoice and interview study to collect data on specific locations that affect young people’s experiences with loneliness, and Group Model Building with experts. Building on this, WP3 aims to co-create spatial interventions with partners and young adults, and test ‘proof of concept’ interventions with virtual environments among young adults. WP3 will result in a spatial intervention toolkit. This project has both societal and scientific impact, as it will provide knowledge on pathways between physical environment characteristics and feelings of loneliness among young people, evidence of what spatial interventions work, and design guidelines that can be used in urban design and management that can contribute to managing loneliness and related health risks.
Psychosocial problems related to social isolation are a growing issue for wellbeing and health and have become a significant societal problem. This is especially relevant for children and adults with chronic illnesses and disabilities, and those spending extended periods in hospitals or permanently living in assisted living facilities. A lack of social relationships, social connectivity, and the inability to travel freely leads to feelings of isolation and loneliness. Loneliness interventions often use mediated environments to improve the feeling of connectedness. It has been proven that the utilization of haptic technologies enhances realism and the sense of presence in both virtual environments and telepresence in physical places by allowing the user to experience interaction through the sense of touch. However, the technology application is mostly limited to the experiences of serious games in professional environments and for-entertainment-gaming. This project aims to explore how haptic technologies can support the storytelling of semi-scripted experiences in VR to improve participants’ sense of presence and, therefore, the feeling of connectedness. By designing and prototyping the experience, the project aims to obtain insights and offer a better understanding of designing haptic-technology-supported storytelling and its potential to improve connectedness and become a useful tool in isolation interventions. The project will be conducted through the process of participants’ co-creation.
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.
