Findings in the context of studies As in the systematic review published in this report, respondents to the national survey perceived the primary effects of stroke to be barriers to community re-integration. Physical deficits, balance and fatigue were cited as the main reasons for curtailment of physical leisure activities. Fatigue and impairment of communication, memory, concentration, vision and physical ability were seen as barriers to returning to work. Reasons for not returning to driving included visual impairment, hemianopia and seizures. Social interaction was affected by aphasia, dysarthria, hearing impairment, fatigue, concentration difficulties and depression. Although problems with mobility, arm function and falling were frequently reported, satisfaction with of treatment received for these physical problems appeared to be higher than for cognitive problems. This reflects the findings of the UK Stroke Survivor Needs Survey. Our results suggest that people experienced high levels of fatigue, emotional, memory and concentration problems after their strokes and many did not feel they received the help that they needed. Associations were found as expected among our sample between physical problems, and referral to community physiotherapy and occupational therapy (OT). Interestingly referral to community OT was not associated with any cognitive or perceptual problems (memory, fatigue, concentration, sight), for which OTs can provide assessment and management strategies. This may reflect a greater focus on physical problems by professionals or it may point to difficulties with treatment of cognitive problems. Emotional challenges emerged from both the systematic review and national survey as significant barriers to community re-integration. Many participants reported depression and anxiety and felt they had not been warned about these symptoms. In contrast positive emotions, including determination and perseverance were seen by respondents as facilitators to recovery. This is supported by findings from the systematic review. Other surveys have demonstrated varying prevalence of emotional problems among stroke survivors. However, in those who report emotional problems there are high levels of dissatisfaction with help and support received across studies. Community psychological services were received by only 17 of our respondents, with 5 of these people paying privately for counselling. The Irish Clinical Stroke Guidelines recommend that stroke survivors and their caregivers should have their individual psychosocial needs reviewed on a regular basis. They suggest that clinical psychologists and social workers provide counselling and support to address issues including adjustment, impact on relationships, loss and coping. Families and spouses of stroke survivors were reported to provide high levels of support, for which respondents expressed gratitude. Significant effects on
Findings in the context of studies As in the systematic review published in this report, respondents to the national survey perceived the primary effects of stroke to be barriers to community re-integration. Physical deficits, balance and fatigue were cited as the main reasons for curtailment of physical leisure activities. Fatigue and impairment of communication, memory, concentration, vision and physical ability were seen as barriers to returning to work. Reasons for not returning to driving included visual impairment, hemianopia and seizures. Social interaction was affected by aphasia, dysarthria, hearing impairment, fatigue, concentration difficulties and depression. Although problems with mobility, arm function and falling were frequently reported, satisfaction with of treatment received for these physical problems appeared to be higher than for cognitive problems. This reflects the findings of the UK Stroke Survivor Needs Survey. Our results suggest that people experienced high levels of fatigue, emotional, memory and concentration problems after their strokes and many did not feel they received the help that they needed. Associations were found as expected among our sample between physical problems, and referral to community physiotherapy and occupational therapy (OT). Interestingly referral to community OT was not associated with any cognitive or perceptual problems (memory, fatigue, concentration, sight), for which OTs can provide assessment and management strategies. This may reflect a greater focus on physical problems by professionals or it may point to difficulties with treatment of cognitive problems. Emotional challenges emerged from both the systematic review and national survey as significant barriers to community re-integration. Many participants reported depression and anxiety and felt they had not been warned about these symptoms. In contrast positive emotions, including determination and perseverance were seen by respondents as facilitators to recovery. This is supported by findings from the systematic review. Other surveys have demonstrated varying prevalence of emotional problems among stroke survivors. However, in those who report emotional problems there are high levels of dissatisfaction with help and support received across studies. Community psychological services were received by only 17 of our respondents, with 5 of these people paying privately for counselling. The Irish Clinical Stroke Guidelines recommend that stroke survivors and their caregivers should have their individual psychosocial needs reviewed on a regular basis. They suggest that clinical psychologists and social workers provide counselling and support to address issues including adjustment, impact on relationships, loss and coping. Families and spouses of stroke survivors were reported to provide high levels of support, for which respondents expressed gratitude. Significant effects on
National-Survey-of-Stroke-Survivors.docx