Social work support and unmet social needs in life after stroke : A cross-sectional exploratory study

Journal article


Lehnerer, Sophie, Hotter, Benjamin, Padberg, Inken, Knispel, Petra, Remstedt, Dike, Liebenau, Andrea, Grittner, Ulrike, Wellwood, Ian and Meisel, Andreas. (2019). Social work support and unmet social needs in life after stroke : A cross-sectional exploratory study. BMC Neurology. 19(1), p. Article 220. https://doi.org/10.1186/s12883-019-1451-y
AuthorsLehnerer, Sophie, Hotter, Benjamin, Padberg, Inken, Knispel, Petra, Remstedt, Dike, Liebenau, Andrea, Grittner, Ulrike, Wellwood, Ian and Meisel, Andreas
Abstract

Background
Stroke patients are often affected by long-term disabilities with needs concerning social issues. There is relatively little consideration of social recovery of patients and the support required to return to work, receive social benefits, participate in daily life activities, maintain contact with family and friends and to organize financial affairs. In our study we aimed to investigate if existing tools record social needs adequately. We analyzed the current provision of social support provided in long-term care after stroke and whether unmet social needs were associated with quality of life, caregiver burden, overall function and degree of disability.

Methods
Our analysis is part of the Managing Aftercare of Stroke study (MAS-I), a cross-sectional exploratory study of patient needs 2–3 years after initial stroke. Assessment tools included the Nikolaus-score (social situation), the EuroQoL (quality of life), the German Burden Scale for Family Caregivers (caregiver burden), the modified Rankin Scale (disability / dependence), Stroke Impact Scale (function and degree of disability) and the Stroke Survivor Needs Questionnaire (unmet needs).

Results
Overall 57 patients were included in MAS-I, with ten patients classified in urgent need of socio-economic support according to the Nikolaus-score. Patients with lower than normal Nikolaus-score had a higher degree of disability. Thirty percent of all patients had never received professional social support. Social worker contact happened mostly during the stay in acute hospital or rehabilitation institution. Only four patients (11%) reported long-term support after discharge. Apart from social worker contact during acute care, 43% of patients had unmet needs in the long-term aftercare. Forty percent of all patients included in MAS-I were recommended for social work intervention after an in-depth analysis of their situation. Finally, we saw that unmet social needs were associated with lower quality of life and higher caregiver burden.

Conclusions
Our data suggest significant unmet needs in social care in long-term stroke patients. Screening tools for unmet social needs such as the Nikolaus-score do not holistically report patients’ needs.

Trial registration
Clinicaltrials.Gov NCT02320994. Registered 19 December 2014 (retrospectively registered).

Keywordsstroke; long-term care; social situation; unmet social needs; assessment tools; screening social work
Year2019
JournalBMC Neurology
Journal citation19 (1), p. Article 220
PublisherBiomed Central Ltd
ISSN1471-2377
Digital Object Identifier (DOI)https://doi.org/10.1186/s12883-019-1451-y
PubMed ID31492151
Scopus EID2-s2.0-85071896856
PubMed Central IDPMC6729017
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range1-10
FunderFederal Ministry of Education and Research, Germany
German Research Foundation
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online06 Sep 2019
Publication process dates
Accepted27 Aug 2019
Deposited25 Aug 2022
Grant ID01EO0801
Exc257
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