Student Number : 9100202J - MPH research report - School of Therapeutic Sciences - Faculty of Health Science / Background and purpose of the research The magnitude of disability observed in stroke survivors is believed to be dependent, in part, on the severity of neurological deficits incurred. As important, but less well understood, is the contribution of physical and environmental factors. The objectives of this study were to establish the degree of functional independence of patients who have had a stroke and to establish factors that influence functional independence post stroke. Research methods and procedures employed This was a quantitative research using a descriptive cross sectional study design. A sample of convenience was derived from patients who had a stroke more than six weeks previously from clinics and a hospital in Johannesburg. The Barthel Index was used to establish the degree of functional independence, and a self-designed questionnaire was used to establish factors that influence functional independence of patients who have had a stroke. Intra and inter rater reliability tests were done to validate the questionnaire. The questionnaire was interviewer administered. Caregivers were interviewed in cases where patients had receptive aphasia. Results: Ninety three percent of the patients were functionally independent post discharge. Younger patients had the highest likelihood of improved functional independence than the older age group (p = 0.003); married patients recovered functional independence faster than those who were single (p = 0.05). The following factors also improved chances of being functionally independent: having bowel continence (p = 0.003); staying in hospital for less than two weeks and more than six weeks; and participating in community (p = 0.02) and household activities (p = 0.01). Having a caregiver decreased the chances of regaining functional independence (p = 0.04). Factors which were found to have no influence on functional independence post stroke were: gender (p = 0.99); education level (p =0.78); duration of stroke (p = 0.58); side of stroke (p = 0.12); shoulder pain (p = 0.90); leg pain (p = 0.22); urinary incontinence (p = 0.53); financial role (p = 0.156); monthly income (p = 0.73); and depression (p = 0.30). Conclusion: Age, marital status, duration of hospital stay and the presence of a caregiver, as well as bowel continence are the factors that influence functional independence post stroke.

Made available in DSpace on 2016-07-27T14:20:37Z (GMT). No. of bitstreams: 1 Mychelle Borges Pereira Pinto.pdf: 494967 bytes, checksum: 9e839594858e583a9be5242d71ac14fb (MD5) Previous issue date: 2005-12-20 / The relations between verbal and non-verbal operant classes have been studied by a field called say-do; do-say correspondence . The present study had the following aims: (1) to verify if successive manipulations of reinforcers and punishments contingent on dependent and independent operants (say/do classes), influence each other; (2) to verify if the effects of the application of reinforcers and punishment on independent operant classes (say/do classes) and (3) to verify if reinforcing and punishing dependent operant classes (say/do classes), correspondence between these operant classes occurs. To realize this study three experiments were done. In experiment I eight university students participated. All of them were exposed to five experimental phases. The results of experiment I showed that contingencies of reinforcement were effective to promoting correspondence between independent operant classes for six of the eight participants. The two other participants did not show correspondence in all phases. In experiment II nine university students participated, being exposed to three experimental phases. The results showed that the contingencies of reinforcement and punishment during phase 2 were effective in promoting correspondence between dependent operant classes. In this experiment two variables were manipulated at the same time. To solve this problem experiment III was outlined. In experiment III, eight university students participated, being exposes to three experimental phases. The results showed that the contingencies of reinforcement and punishment during phase 2 were effective in promoting correspondence between independent operant classes. Experiment III was outlined to identify what variable controlled the behavior of the participants. The results showed that the controlling variable was the relation of functional dependence. Together, these experiments made it possible to verify that correspondence is a phenomenon that can be established through contingency procedures, or, when dependency contingencies between operant classes are organized, the probability of correspondence between saying and doing to occur. / As relações entre classes de operantes verbais e não-verbais foram estudadas em uma área denominada de correspondência: dizer-fazer; fazer-dizer. O presente estudo teve como objetivos: (1) verificar se manipulações sucessivas de reforçadores e punições contingentes a classes de operantes dependentes e independentes (classes de dizer/fazer), influenciam uma às outras; (2) verificar os efeitos da apresentação dos reforçadores e da punição de classes de operantes independentes (classes de dizer/fazer) e (3) averiguar se reforçando e punindo classes de operantes dependentes (classes de dizer/fazer), ocorre correspondência entre essas classes de operantes. Para realizar este estudo foram desenvolvidos três experimentos. No Experimento I participaram oito estudantes universitárias. Todas foram expostas a cinco Fases Experimentais. Os resultados do Experimento I demonstraram que contingências de reforçamento foram efetivas para promover correspondência entre classes de operantes independentes para seis das oito participantes. As duas outras participantes não fizeram correspondência em todas as Fases. O Experimento II contou com a participação de nove estudantes universitárias, expostas a três Fases Experimentais. Os resultados mostraram que as contingências de reforçamento e punição durante a Fase 2 foram efetivas para promover correspondência entre classes de operantes dependentes. Neste experimento foram manipuladas duas variáveis ao mesmo tempo. Para resolver este problema foi delineado o Experimento III. No Experimento III, participaram oito estudantes universitários expostos a três Fases Experimentais. Os resultados demonstraram que as contingências de reforçamento e punição durante a Fase 2 foram efetivas para promover correspondência entre classes de operantes dependentes. O Experimento III foi delineado com o objetivo de identificar qual variável estava controlando o comportamento das participantes. Os resultados demonstraram que a variável controladora foi a relação de dependência funcional. O conjunto de experimentos possibilitou verificar que a correspondência é um fenômeno a ser estabelecida via procedimento de contingenciamento, ou seja, quando se organiza as contingências de dependência entre classes operantes, aumenta-se a possibilidade de ocorrer correspondência entre Fazer e Dizer.