Dataset Information

Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design.

ABSTRACT:

Objective

The wide range of outcomes after stroke emphasises the need for comprehensive long-term follow-up. The aim was to evaluate how people with stroke and health professionals (HPs) perceive the use of the poststroke checklist (PSC), with a focus on feasibility and relevance.

Design

An exploratory design with a mix of qualitative and quantitative methods.

Setting

Outpatient care at a university hospital and primary care centres in western Sweden.

Participants

Forty-six consecutive patients (median age, 70; range, 41-85; 13 women) and 10 health professionals (median age 46; range, 35-63; 7 women).

Results

Most patients (87%) had one or more problems identified by the PSC. The most common problem areas were life after stroke (61%), cognition (56%), mood (41%) and activities of daily living (39%). Three organisational themes emerged from the focus group discussions. The perception of the content and relevance of the PSC was that common poststroke problems were covered but that unmet needs still could be missed. Identifying needs was facilitated when using the PSC as a tool for dialogue. The dialogue between the patient and HP as well as HPs stroke expertise was perceived as important. The PSC was seen as a systematic routine and a base for egalitarian follow-up, but participants stressed consideration given to each individual. Addressing identified needs and meeting patient expectations were described as challenging given available healthcare services.

Conclusions

The PSC is a feasible and relevant tool to support egalitarian follow-up and identify patients who could benefit from targeted poststroke interventions. Stroke expertise, room for dialogue and caring for identified needs emerged as important issues to consider when using the PSC. Nutrition, sexuality and fatigue were areas mentioned that might need to be addressed within the discussions. The PSC can facilitate patients in expressing their needs, enhancing their ability to participate in decision-making.

SUBMITTER: Kjork EK

PROVIDER: S-EPMC6528008 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design.

Kjörk Emma K EK Carlsson Gunnel G Sunnerhagen Katharina S KS Lundgren-Nilsson Åsa Å

BMJ open 20190509 5

<h4>Objective</h4>The wide range of outcomes after stroke emphasises the need for comprehensive long-term follow-up. The aim was to evaluate how people with stroke and health professionals (HPs) perceive the use of the poststroke checklist (PSC), with a focus on feasibility and relevance.<h4>Design</h4>An exploratory design with a mix of qualitative and quantitative methods.<h4>Setting</h4>Outpatient care at a university hospital and primary care centres in western Sweden.<h4>Participants</h4>Fo ...[more]

PMID: 31072862

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Project description:BackgroundPulmonary rehabilitation (PR) is an effective and essential component of care for the increasing number of individuals with chronic respiratory diseases (CRDs). Despite the benefits, it remains underutilised and poorly accessible in low- and middle-income countries (LMICs). We aimed to determine the feasibility of delivering PR in Bangladesh at home because of pandemic travel restrictions.MethodsAligned with the Medical Research Council framework of development and evaluation of complex interventions, we recruited individuals with CRDs from the Community Respiratory Centre, Khulna, to a mixed-methods feasibility study. We assessed their functional exercise capacity and quality of life before and after an eight-week course of home PR, and conducted semi-structured interviews with PR providers and professional stakeholders by using a topic guide aligned with the normalisation process theory (NPT) and interpreting the findings within its constructs.ResultsWe recruited 51 out of 61 referred patients with a range of CRDs, of whom 44 (86%) completed ≥70% of their home PR course. Functional exercise capacity, measured by the endurance shuttle walk test, improved in 78% of patients, with 48% exceeding the minimum clinically important difference (MCID). Health-related quality of life, measured by the Chronic Obstructive Pulmonary Disease Assessment Test, improved by more than the MCID in 83% of patients. Through the interviews, we found that PR providers encountered challenges in remote video supervision due to unstable internet connections, forcing them to resort to telephone calls. The strength of support for NPT constructs varied; many participants understood and appreciated the role of PR and could make sense of the innovation (NPT-1), and most were assessing the potential of a PR service in Bangladesh to decide if it was worthwhile (NPT-4). Participants were not yet ready to endorse or actively support (NPT-2) or operationalise (NPT-3) the roll-out of PR.ConclusionsA home PR programme, supported by remote supervision and monitoring, is feasible in Bangladesh, but local evidence will be needed to promote implementation.

Dataset Information

Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design.

Objective

Design

Setting

Participants

Results

Conclusions

Publications

Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design.

Similar Datasets

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