Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke : an explorative observational study

BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08). CONCLUSIONS: Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.

Childbirth self-efficacy inventory in Tanzania : a pilot study

Background. To give birth can be a stressful experience and women cope with thisstress in many different ways and have different personal outcomes. Self-efficacy orconfidence in ability to cope with labour can be considered as an important factoraffecting pregnant women’s motivation of normal childbirth and their interpretation ofthe childbirth event.The aim. The purpose of this study was to test the Chinese short form of theinstrument Childbirth self-efficacy instrument (CBSEI) in Tanzania, that measurepregnant women’s self-confidence and coping abilities during childbirth.Method. The Chinese short form of the CBSEI was used to pilot test the pregnantwomen’s confidence of childbirth to see if the questions were understood in theTanzanian culture. Besides this instrument socio-demographic data was collectedtogether with two open questions asking about attitudes and experiences of childbirth.The instrument was translated into Kiswahili. A sample of 60 pregnant women whowere visiting antenatal clinic (ANC) regularly were asked to participate and with helpfrom midwifes at two ANC places the questionnaires were filled out.Result. The result shows that the validity and reliability of the two subscales OE-16and EE-16 were established. The internal consistency reliability of the two subscaleswere high, suggesting that each of the subscale mean score provides a good overviewof self- reported belief in coping ability for childbirth.The results further show that the instrument, CBSEI in this pilot study is not able toidentify women who need extra support during childbirth.Conclusion. The reliability and validity of information presented in this pilot studysupport the use of the Chinese short form of the CBSEI as a research instrument in theTanzania culture. Further studies are recommended to get a wider understandingabout women’s coping abilities in a culture like Tanzania.

Profiling visitors to Dalarna Museum : What are the motivational factors that influence visitors' frequency of visits

Prior studies on museum visitors are extensively centred on national museums, the studies on regional museums are scarce. To fill in the academic gap, a research is proposed concerning the visitors of Dalarna Museum, a regional museum in Sweden. With an aim to profile visitors’ demographic characteristics and investigate the motivational factors that influence visitors’ frequency of visits, a face-to-face questionnaire survey was implemented at Dalarna Museum. To get visitors’ demographic characteristics, a few closed and open questions are devised to profile visitors’ gender, age, occupation, income, education, number of children and residence place. To investigate the motivational factors that influence visitors’ frequency of visits, a seven-point Likert questionnaire is employed with 17 motivational factors included. During a 12-day data collection, 372 visitors were invited to participate in the questionnaire survey, whereof 357 had filled in the questionnaire, generating a response rate that is as high as 96 percent. After data cleansing, there are 355 completed and valid responses in total. According to the results, some of visitors’ demographic characteristics are similar including gender, age, occupation, income, and number of children. However, the characteristics regarding visitors’ residence places and educational attainments are different comparing the frequent visitors to occasional visitors. Through running a multiple regression analysis, 13 out of the 17 motivational factors are detected having significant influences on visitors’ frequency of visits to Dalarna Museum, of which the most influential one is visitors’ day-outs with their friends and relatives.