Current Research Projects

Integrative Health Coaching Post-Stroke: A Pilot Pre-Post evaluation of the ARCH-PEER Programme.
(*ARCH- Aspirational Rehabilitation Coaching for Holistic Health. PEER- Peer Enriched Environment for Recovery)

• Project Duration: 2023-2026
• Principal Investigators: Dr. Andy Hau Yan Ho
• Grant Awarding Agency: Funded by the SG Enable – The Enabling Lives Initiative (ELI) Grant
• Amount Awarded: S$ 644,920
• Abstract of Research: The aftermath of stroke is complex, multifaceted, and simultaneously affects both patients and their families. The impact of stroke extends beyond one’s physical functioning, affecting one’s psycho-socioemotional and spiritual health.  This is exacerbated by the discontinuity of care as well as limited support to cultivate patient’s self-management skills beyond hospital settings. Hence, the current proposal aims to develop and evaluate the effectiveness of a novel, multi-modular, individualized, and strength-based health coaching intervention that seeks to support first-time stroke survivors and their family caregivers. The intervention will comprise two unique, and interconnected programmes, integrated to build psycho-socio-emotional coping strategies and self-management skills for lasting recovery.
• Aspirational Rehabilitation Coaching for holistic Health (ARCH) in Psychosocial Stroke Recovery: A Pilot Pre-Post Study with First-Time Stroke Survivors and Family Caregivers : The Aspirational Rehabilitation Coaching for holistic Health (ARCH) programme is an 8-week long dyadic intervention integrates psychoeducation with self-reflective practices and dignity-enhancing techniques as the primary psychotherapeutic intervention to strengthen and cultivate mutuality among the dyads, enhancing their psychological and emotional well-being and quality of life. By facilitating the creation of positive life meaning from their experiences, the ARCH programme ultimately aims to build sustainable hope and mental resilience for physical recovery and the provision of caregiving following the aftermath of a stroke event.
• Peer Enriched Environment for Recovery (PEER): Development and Pilot Evaluation of a Holistic PEER Coaching Programme for Stroke Survivors:  Running parallel to the quasi-experimental study, the Peer Enriched Environment for Recovery (PEER), a peer-led coaching program, will be developed and evaluated using the framework of the Participatory Action Research (PAR) design. This design stipulates the active collaboration of health care professionals, researchers, patients, and their families (multi-stakeholder) to ensure sustainability and feasibility of the program. The primary aim of the PEER programme is to instill self-management skills through a peer-to-peer learning environment post-stroke. The trained stroke coaches and programme content developed will be rolled out in the ARCH-PEER Quasi experimental study.
• Outcomes of this study will provide relevant stakeholders in the healthcare system and the community a holistic family-centered framework to support, guide, and empower Singaporean families through the trajectory of stroke rehabilitation and recovery. The proposed intervention provides stroke survivors and their families the continuity of care in the form of ongoing, community-based, outpatient rehabilitation and support. It aspires to build a compassionate, family-centered ecosystem that is sensitive to their needs, accessible throughout the course of recovery and integrated with social and community services.

The Table to Console: A Novel Psychotherapeutic Culinary Grief Intervention (CGI) for Bereaved Family Caregivers in Singapore

• Project Duration: 2022-2024
• Principal Investigators: Dr. Andy Hau Yan Ho
• Grant Awarding Agency: Funded by the Palliative Centre for Excellence in Research and Education (PalC) Research Grant
• Amount Awarded: S$ 49,670
• Abstract of Research: Food and its myriad of psycho-socio-emotional experiences are integral to human existence throughout and even at the end-of-life. A person’s lifetime stories of and meaning with food can uniquely aid grief work for their loved ones following their deaths. However, food has not been studied as a medium of psychotherapeutic intervention for loss and bereavement. “The Table to Console” is a novel and innovative psychotherapeutic Culinary Grief Intervention (CGI)” conceived by the research team. It is empirically informed by the team’s signature investigation on the lived experiences of ‘living and dying with dignity’ among terminally ill patients and their family caregivers in Singapore, as well as a series of pioneering intervention studies designed to enhance holistic end-of-life care and bereavement support services in Asia. This 2 year study will test the effectiveness and efficacy of CGI in supporting bereaved individuals to experience enhanced quality of life, spiritual well-being, hope and perceived social support, as well as reduced levels of depressive symptoms and grief reactions. The expected findings from this first-of-its-kind study will serve as the foundation for a full-scale RCT for advancing holistic end-of-life care and meaning-centered culinary-based bereavement support locally and internationally.

 

Identifying Care Needs and Measuring Longitudinal Outcome Holistically for Acute and Chronic Stroke Patients

• Project Duration: 2019-2023
• Overall Technical Principle Investigator: Dr Andy Hau Yan Ho
• Grant Awarding Agency: Rehabilitation Research Institute Singapore (RRIS) Rehabilitation Research Grant 3 – Complementary Grant
• Amount Awarded: 296,700
• Abstract of Research: Local studies on stroke outcomes have generally shown gain in global indicators after inpatient rehabilitation. However, knowledge gaps remain regarding chronic stroke survivors of beyond 5 years post-stroke, specific stroke subgroups such as young stroke or aphasic stroke, dynamic changes in outcomes within the first year after stroke, as well as the specific factors influencing global measures. Through this study, we aim to firstly, use a person-centred approach to identify the care needs of acute stroke versus chronic stroke; secondly, to use a holistic approach towards measuring and comparing outcomes of acute versus chronic stroke; and thirdly, to describe the longitudinal trajectory of changes in care needs and outcomes from up to 1 year post-stroke to at least 5 years post-stroke. With this data, we will be able to formulate value-added care services to current stroke care bundles, particularly the inclusion of psychosocial care as well as generate hypotheses for new approaches towards interventions for specific stroke subgroups and generate new indicators for measuring outcomes of health services.

 

A Longitudinal Mixed Method Study on Psychosocial Quality of Life Trajectories of First-Time Stroke Patients and Their Family Caregivers in Singapore

• Project Duration: 2019-2023
• Principle Investigator: Dr Andy Hau Yan Ho
• Grant Awarding Agency: Rehabilitation Research Grant Institute of Singapore, Rehabilitation Research Grant 3 (RRG3)
• Amount Awarded: S$299,988
• Abstract of Research: Stroke affects patients as a whole and the effects go beyond physical/cognitive impairments, influencing their psychological wellbeing, social relationships and quality of life (QoL), as well as those of their family caregivers. Despite substantial research conducted in Western societies has identified the rehabilitation needs and recovery outcomes of stroke survivors and caregivers, most research adopt either a quantitative or qualitative investigative approach that focus solely on patients or caregivers alone, thus, a holistic and cultural-specific understanding of the lived experience of stroke rehabilitation and caregiving is greatly lacking in the local Singaporean context. This study adopts a longitudinal mixed method design with the aims to: (1) identify the psycho-socio-emotional-spiritual needs of a representative sample of first-time stroke patients and their caregivers through a series of quantitative assessments; (2) explore the lived experience a nest sample of first-time stroke patients and their caregivers through a series of qualitative meaning-oriented interviews. Sample for the quantitative study will comprise 166 families in Singapore, inclusive of one first-time stroke patient and one identified family-carer whom the patient considers to be his or her primary caregiver (N=332). 30 families will be purposively drawn from the quantitative sample to participate in the qualitative study concurrently. Assessments and interviews will conducted at four time points including 1 month post inpatient care discharge [T1], 3-month [T2], 6-month [T3] and 12-month [T4] follow-up. A holistic framework for understanding the Singaporean QOL trajectory of stroke rehabilitation and recovery will be established.