**9.1 Syllabus**

Based on the findings from the targeted needs assessment, the syllabus for the training programme includes information on the condition and presentation of stroke, physical changes, causes, complications and risk factors, and related

**329**

**Table 2.**

*Supporting Survivors of Stroke in Low Resource Settings DOI: http://dx.doi.org/10.5772/intechopen.86900*

Step 3. Developing goals and objectives

Step 4. Developing educational strategies

likely to achieve the educational objectives.

Step 5. Implementation

Caregivers of stroke survivors

Support from communities of

**Underlying Assumptions:**

• Government policies and resources are supportive

*Logic model for the training programme implementation [166].*

• The total health care system is improved to support the work of caregivers

Stroke survivors Training materials Places where training will

be held

interest.

diseases are also included. The syllabus also addresses the activity limitations, participation restrictions and treatment needs of the stroke survivors in a practical way. **Table 1** presents the notes to assist with topic development for training.

cate what the curriculum is about and provide the basis for evaluation.

After identifying the needs of caregivers and the stroke survivors, goals and objectives for the training programme are developed. The objectives may include cognitive (knowledge), affective (attitudinal) and psychomotor (skill and behaviour) for the caregivers and stroke survivors. Objectives help determine the content of the training programme, learning methods/educational strategies and communi-

Educational strategies are based on the objectives and the content of training programme. After the educational needs of caregivers and stroke survivors have been identified, it is decided on what has to be taught based on the needs and the methods of delivery that will be effective. The selected strategies are the ones most

Implementation of the training programme includes getting buy-in from the people who will allow use of the training programme, and the identification of any barriers to the use of programme. Usually these are the health professionals who will do the training later on or even Directors of health who have to enforce the training of caregivers and stroke survivors. The programme is introduced and

**Resources Outputs Program outcomes Impact**

• The caregiver training program is fully implemented with fidelity to written goals and objectives.

All caregivers of stroke survivors are knowledgeable, compassionate, dedicated in caring for stroke survivors. Caregivers of stroke survivors demonstrate competencies in the following areas: Explaining the causes and symptoms of stroke Explaining how to handle and lift a patient with

Hospitals have optimal holistic health care that reduces the impact of stroke on caregivers and people who have survived a stroke.

stroke

daily living.

Can handle, lift, mobilise and help a stroke survivor to perform activities of

CGs have confidence and good attitude in dealing with problems of stroke Stroke survivors have increased access to home based support.

Number of CGs enrolled Number of caregivers trained Number of drop

outs Number of caregivers who develop competencies in looking after stroke survivors Number of CGs who are satisfied with the training program Number of CGs confident to look after SS after training

#### **Table 1.**

*Notes to assist with topic development [166].*

*New Insight into Cerebrovascular Diseases - An Updated Comprehensive Review*

**Topic Notes to assist with topic development**

potential problems

on caregiver

length of time.

Complications and prevention of stroke

**9.1 Syllabus**

triangulation of methodologies is used to come up with their needs and challenges that they face. This should be done among those that are likely to have faced challenges, meaning that they have experienced the challenges for a certain

Based on the findings from the targeted needs assessment, the syllabus for the training programme includes information on the condition and presentation of stroke, physical changes, causes, complications and risk factors, and related

The disease stroke What is stroke? What are the causes of stroke? How does stroke present?

Identifying stroke Use appropriate evaluation procedures to assess psychological and physical

Problems that patients face These range from sudden change in body image, immobility, dependence

Problems that caregivers face Sudden changes from being thrust into caregiver role. Patient dependent

system, particularly incontinence Progression time frames Changes in status from flaccidity to spasticity, immobility to mobility and

Comorbidities Additional diseases that may be found in stroke patients such as HIV and

Infection control Use of gloves and disinfectants to minimise exposure to HIV and other

and transferring techniques for safety reasons. Activities of daily living Teach feeding, bathing, toileting and alternatives to assist with dressing and any other personal activities of daily living

Handling of stroke patients Handling and training for positioning, preventing shoulder-hand syndrome and shoulder subluxations Lifting and transfers Different methods of lifting stroke patients. Use of one-man method as

Treatment Devising a plan of care for treatment that includes an appropriate

Communication Tailored to the needs of each individual with identification and referral to

depression, acceptance and that the cycle may repeat.

caregivers and members of the health care team.

Dealing with bereavement Explain the different stages of bereavement from shock, anger, denial,

patient's progress.

recovery of lost function.

other potential infections

potential infections

How is the diagnosis made? What is the prognosis?

state of patients. Accurate identification of the patient's immediate and

on others for activities of daily living and care and personality changes. Also includes fears of loss of self-care and income and insecurities

Changes in motor and sensory problems. Secondary issues from immobility in cardio-respiratory and muscular skeletal systems. Issues with urinary

well as methods for patients who are completely dependent. Help with facilitation of mobility and transfers as well as correct application of lifting

progression and post discharge program of management. Recognition of contraindications and precautions for treatment, delivery of effective treatment and progression based on regularly scheduled evaluation of the

appropriate resource persons or sources within the hospital and community

Establishment of appropriate relationships with the patient and other

**328**

**Table 1.**

Role of different departments and of the community in patient care

*Notes to assist with topic development [166].*

diseases are also included. The syllabus also addresses the activity limitations, participation restrictions and treatment needs of the stroke survivors in a practical way. **Table 1** presents the notes to assist with topic development for training.

Step 3. Developing goals and objectives

After identifying the needs of caregivers and the stroke survivors, goals and objectives for the training programme are developed. The objectives may include cognitive (knowledge), affective (attitudinal) and psychomotor (skill and behaviour) for the caregivers and stroke survivors. Objectives help determine the content of the training programme, learning methods/educational strategies and communicate what the curriculum is about and provide the basis for evaluation.

Step 4. Developing educational strategies

Educational strategies are based on the objectives and the content of training programme. After the educational needs of caregivers and stroke survivors have been identified, it is decided on what has to be taught based on the needs and the methods of delivery that will be effective. The selected strategies are the ones most likely to achieve the educational objectives.

Step 5. Implementation

Implementation of the training programme includes getting buy-in from the people who will allow use of the training programme, and the identification of any barriers to the use of programme. Usually these are the health professionals who will do the training later on or even Directors of health who have to enforce the training of caregivers and stroke survivors. The programme is introduced and

**Underlying Assumptions:**

#### **Table 2.**

*Logic model for the training programme implementation [166].*

administered. Implementation is critical for success of programme as it converts a mental exercise into reality [8]. A logic model (**Table 2**) is used to help with the implementation process as exemplified below.

Step 6. Evaluation and feedback

In this phase the caregivers and stroke survivors as well as the training programme are evaluated. This may be either formative (at the beginning) or summative (at the end) [8]. Evaluation of the content and delivery of the programme to caregivers is important as it leads to its acceptance [42, 172]. Evaluation is also important for recognition of caregiver and stroke survivor needs during and after training leading to appropriate and timeous interventions which are perceived as beneficial by the caregivers and the survivors of stroke [180].


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