|Title||Improving outcome in stroke survivors with visual problems: Knowledge translation in a multidisciplinary stroke unit intervention study|
|Author, Co-Author||Helle Falkenberg, Irene Langeggen, Heidi Ormstad, Grethe Eilertsen|
|Abstract|| Aim: Visual problems affect >60 % of stroke survivors, but are often overlooked due to lack of knowledge and structured assessments in stroke units. Problems include reduced visual acuity, visual field defects, eye movement disorders and perceptual deficits, and range from insignificant vision loss to total blindness. Impaired vision is a risk factor for falls, reduced quality of life, activities of daily living, and additional distress. Early vision rehabilitation has positive implications for the outcome after stroke. The aim of this intervention was to improve outcome in stroke survivors by developing and implementing a clinical vision assessment tool in multidisciplinary stroke units.
Methods: The intervention and vision assessment tool were developed using the two Knowledge-to-action (KTA) framework components; knowledge creation and the action cycle. Based on the KTA multiple phases, the tailored intervention included a 2.5 days training program and implementation of a vision-screening tool. 43 hospital staff from two stroke units participated, and included optometrists, ophthalmologists, nurses and occupational therapists. Evaluation included group interviews with 9 staff, and an eye exam of 30 patients at the University Eye clinic.
Results: Interviews revealed that the vision tool is used routinely, and the competence of detecting visual loss after stroke has increased. Preliminary results from 17 patients show 7 were aware of vision changes; 8 had visual field loss; 8 reduced VA; 3 diplopia and 1 had neglect. The vision tool identified these problems.
Discussion: The KTA framework is useful in the development of clinical tools and complex interventions. Identifying barriers and tailoring the vision tool to the stroke unit settings were key issues to implementing and sustaining the intervention. The intervention has improved the outcome of stroke survivors. More research is needed to ensure vision is tested in all stroke patients before leaving the hospital.
|Affiliation of Co-Authors||University College of Southeast Norway, University College of Southeast Norway, University College of Southeast Norway|