This study examined the effect of discharge living arrangement on independence in self-care for patients with stroke. Data on 1.058 patients with stroke who met a set of inclusion criteria were provided by the Uniform Data System for Medical Rehabilitation. It was hypothesized that individuals who were discharged home alone would have greater follow-up self-care FIM scores and greater improvements in self-care than those who were discharged to a SNF when controlling for age, length of stay, admission, and discharge self-care FIM scores. To test these hypotheses, the follow-up self-care FIM scores and the self-care change scores of patients who were discharged home alone had significantly (p

Despite the improvements that have been made in health care over the years, stroke remains a serious public health problem in low, middle and high-income countries. Informal caregivers are particularly important in low resourced settings. The aim of the study was to establish the impact of caregiver education on stroke survivors and their carers. This was done using a randomised controlled trial with a total of 200 patients and their caregivers. From the study, the one-year case fatality was 38%. About 78% of the patients were functionally dependent at 12 months post discharge. Caregiver education had the effect of improving the BI scores by one and 0.7 at the three and 12 months follow ups respectively and improved patients' EQ-5D scores by a factor of three at 12 months. The patient ability to socialise and participate in community issues post-stroke is currently poor due to poor functional ability levels, necessitating dependency on caregivers. Structured and individualised caregiver training has the effect of improving patients' quality of life and can help reduce deaths among stroke survivors.

Research has shown that caregivers face strain associated with the devastating effects of a stroke to a family member. The unexpected effects of a stroke can cause caregivers to experience physical, mental, and spiritual strain. Changes often have to be made to their own personal and financial plans to accommodate appropriate care. The Modified Caregiver Strain Index (MCSI) can be used to assess the constraints of a stroke on caregivers and their family. Nurses have the responsibility of taking care of their patients and their caregivers as a whole. A stroke education folder including mandatory stroke education, a flyer for a free weekly "Homeward Bound" class, Krames "Stroke Recovery: A Caregiver's Guide" pamphlet, and a Caregivers Guide to Stroke pamphlet will be developed. A study by Mant, Carter, Wade, and Winner (1998) found that information packs increased education, satisfaction, and attributed to better caregiver mental health.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Constraint-Induced Movement therapy (CI therapy) is a behavioral approach to neurorehabilitation based on a program of neuroscience experiments conducted with monkeys. Evidence has accumulated to support the efficacy of CI therapy for rehabilitating hemiparetic arm use in individuals with chronic stroke. This book addresses the related topics.