Evaluation of a multiprofessional community stroke team Essay

The larn aims to conclusively evaluate how effective it is to employ a specialiser union bezzant aggroup for the rehabilitation of bezzant victims in a community found setting. This is clear established at within the spread lines of the article. In the summary at the beginning of the article the author claims that the procurable licence is inconclusive and his aim is to provide conclusive proof with regards to evidence based practise for the patient. A research article should press out its aims clearly and should assume the audience has no preceding background familiarity (Greenhalg, 2006).The lit produce offed in this article was from a variety of sources such as the Cochrane database and a selection of journal articles. On this basis the authors were able to deduce that previous research carried out provided contradicting reports. For example Roderick et al (2001) as cited by capital of Nebraska et al (2004) found no signifi sightt difference in the effectiveness of rehabilitation which had taken place in the home to that which had occurred in a hospital setting. On the contrary Gladman et al (1993) as cited by capital of Nebraska et al (2004) found a significant difference in a small group of younger patients.It was also suggested that there was a electric switch of focus from mainly hospital based rehabilitation to community based rehabilitation of stroke patients. jibe to Polger and Thomas (2008) a literature review should provide appropriate background information. That is, it should show the current knowledge level in that area of nurture. The author appears to conduct utilised much of his testify previous work in the subscribe to and some are more than than ten years old. This could possibly be an indication that indeed, there is a large gap in knowledge of this subject area.On the early(a) hand it may indicate that the author has done a selective search of the literature. A quantitative approach was utilised in this show and t he method employ was a Randomised Controlled Trial (RCT). The articles methodology was puff up documented. According to Sim and Wright (2000) an analytic study attempts to quantify the relationship between cardinal factors, that is, the effect of an intervention or exposure on an outcome. A bourn used to describe the design randomised controlled psychometric test agree to Greenhalgh (2006) is parallel group resemblance.This is when each group receives a different treatment and both are entered into the experiment at the same time. By comparing the groups an depth psychology is provided. In the capital of Nebraska et al (2004) study Participants were divided into twain groups, A and B with the former receiving routine care while the latter authoritative the intervention rehabilitation with the multi-professional community stroke team. The question posed by the authors could project been answered using a qualitative approach. The question could possible press out Evaluat ion of a multiprofessional community stroke team a phenomenological study. ingest Altman (1991) states that a study should have enough participants recruited in order to observe a significant effect if one exists. The prototype group consisted of patients referred to the Nottingham lodge byzant Team who had suffered a stroke within the last devil years, who were over sixteen years old and needed intervention from more than one multidisciplinary team member. Patients who lived outside the geographical area and/or had been tempered by the community stroke team in the preceding two years were excluded.Four hundred and twenty eight patients were randomly selected at the start of the trial and randomly allocated to either Group A or Group B. An mistake resulted in seven people universe recruited twice. This error was corrected by including only the outcome of their initial recruitment when the results were organism analyzed. The target race of this study is relatively clearly def ined (patients who have had a stroke within last two years, over the mature of sixteen, etc ) and lends credence to the external validity of the study (Payton, 1994).According to Sim and Wright (2000) the accessible world is the portion of the target population that is available to the investigator and the sample is thusly taken from this accessible population. The groups are similar to each new(prenominal) with regards to sexual practice and age distribution this also increases the validity of the study as this proportion reduces the variables of the study. The overall population was a convenience sample which was then randomized to two groups.Six months after randomization all the patients were sent a letter asking them to consent to being in a study to evaluate the input of a community stroke team. According to Lincoln et al (2004) the consent forms and outcome questionnaires were sent this late so as to reduce bias. It was thought that group A which was receiving routine care would have lower expectations if confronted with the realization that the alternate group may receive superior care. Some would possibly insist on being referred to the specialist community stroke team The Local Research Ethics Committee give ethical approval for this study to go ahead.This indicates that the value of the research undertaken outweighed each harm that this consenting method may have caused as patients in Group A were still receiving routine care. up to now, the department of health has issued guidelines which state that participants must be consented and all pertinent information given previous to the start of any study. Data was collected via a questionnaire comprising of the Barthel Index, Extended ADL, full general Health Questionnaire 12 (GHQ-12) and Euroquol.The participants were also asked to rate their knowledge of the expected purpose of recovery from their stroke, and their overall joy with the services they received from the community stroke tea m. The use of a questionnaire for data gathering has both negative and positively charged aspects. Greenhalgh (2006) states that a questionnaire is an instrument used to measure human psychology, so whilst displace the questionnaire via post proves to be cost effective as the alternative would be to hold face to face interviews with the participants as focus groups or individually, it raises concerns virtually the reliability of the study.This is because the researcher is non present to interpret facial expressions and form language when the participants answer the questions. The alternative of conducting face to face interviews with such a large number of participants would prove to be costly and time consuming. However, according to Oppenheim (2003) long questionnaires are sometimes off putting and may buzz off low response rates, conducting these questionnaires via the postal service could possibly increase the likelihood of a low response rate.The results were shown as a table and diagram, the Mann-Whitney U-test which was used to compare the groups showed no significant differences on independence in ad hominem or instrumental activities of daily living or on the patients mood. in that respect was also no significant difference between the groups in their knowledge with regards to the resources available to assist them in adjusting to life after a stroke. at that place was also no difference between the two groups with overall satisfaction or in satisfaction with the practical helped received.However, patients in the Community Stroke Team were significantly more satisfied with the horny care they received. (Lincoln et al, 2004) According to Wright et al (2009) the Mann-Whitney U-test is used when one group from the sample is larger than the other and when both samples are from the same population, as is the case with this study. There was no significant difference in carers mood between the two groups. However, the mannikin on carers of patien ts seen by the community stroke team was significantly little than that of carers of patients randomized to the routine care group.The carers of patients in the community stroke team group were significantly more satisfied with their knowledge of stroke and had higher(prenominal) overall satisfaction than the carers of those in the routine group. By utilizing the randomized controlled trial design the author lends credence to its validity as this design allows for the eradication of systematic bias. (Sim et al, 2000) This was done through the sampling process of selecting the participants from the target population and randomly allocating them to Group A which received routine care or Group B those in the care of the community stroke team.The collection of data by using a postal questionnaire helps to blind the researcher as he cannot influence the participants response. Although some participants did not respond to the questionnaire, others responded with fractional forms, some d ied and a few were recruited twice, the author is cognizant of this and incorporates it into his findings. Crombie (2000) states that if the withdrawals and failures to respond can be seen as being consistent between both comparison groups then the results of the research will not be negatively squeeze upon.This is because the results show that these failures are random among both groups and not specific to one. However one major fault is the fact that the services received by Group A were not collected due to impracticalities and unreliable recollections of the patients. little appraisal is not just an exercise in fault finding, it is the abstract of these faults and the assessment of their potential impact on the research which allows the reader to come to a decision regarding the strength or usefulness of the article being critiqued.In order for the research results to be utilized in clinical practice its reliability and validity are essential aspects which need to be covered. (Polger and Thomas, 2008) This article shows a research that was methodically sound and well designed. The sample was representative of the population being examined and attempts were made to minimize bias. The author was alert of the shortfalls of this research and attempted to incorporate this in his findings however, most of the issues identified did not affect the results of the study. The study if repeated would provide comparable results.However, the author states that the study provides evidence supporting the use of a community based stroke team to assist in the rehabilitation of stroke patients because of the increased excited support for patients and greater satisfaction and reduced strain on carers. This tilt would have been better justified on results from a qualitative study as this type of study aims to interpret peoples emotional and psychological response to the intervention or interventions being employed. The results from such a study would be closer to the pat ients and carers true feelings as the methodology base that study would be different.