Development of a tool to support person-centred medicine-focused consultations with stroke survivors

Abstract

2019) Development of a tool to support person-centred medicine-focused consultations with stroke survivors. Patient Education and Counseling . ISSN 0738-3991. Abstract ObjectiveTo develop a tool to support medicine-focused person-centred consultations between community pharmacists and stroke survivors. MethodSemi-structured interviews with 15 stroke survivors and 16 community pharmacists were conducted.Thematic analysis of the data was performed and emerging themes examined to determine their relevance to the principles of delivering person-centred care. Findings were used to generate a framework from which a consultation tool was created. Face validity and the feasibility of using the tool in practice were explored with participating pharmacists. ResultsThree major themes were identified; personal, process and environmental factors. A tool, in two parts, was developed, A 'Getting to know me' form which would help the pharmacist to appreciate the individual needs of the stroke survivor and a consultation guide to facilitate the consultation process.Pharmacists considered that both were useful and would support a person-centred medicine-focussed consultation. ConclusionA consultation tool, reflecting the needs of stroke survivors, has been developed and is feasible for use within community pharmacy practice. Practice ImplicationsPharmacists must recognise the individual needs of stroke survivors to ensure that they provide consultations which are truly person-centred.The tool developed could support medicine-related consultations with patients with other long term conditions.Optimising communication  Take into account the individual's specific needs before you start -you will probably need to explore these in more depth during the first consultation Remember -the patient is often an expert about living with their condition  Introduce yourself as the pharmacist, don't assume stroke survivors know you as the pharmacist, and explain what you are going to do -i.e. to help them with their medicines  Don't speak too quickly  Allow the person time to speak -listen actively and be sure to not interrupt or finish sentences  Keep sentences simple and concise  Don't keep moving between topics -changing subjects quickly can be confusing  Don't seem rushed -appear relaxed, approachable and that you have time  Use repetition -i.e. to reinforce important points and to check understanding (visually/verbally)  Make sure that you always include the stroke survivor in the discussion -keep face to face contact with the stroke survivor -especially in the presence of carers  Use communication tools wisely -they can be useful if someone has memory or communication difficulties -but leaflets are not any good if you cannot read  Sometimes it is better to ask short yes/no questions instead of open questions  Check reliability of responses -some stroke survivors may jumble their words -'no' might mean 'yes'! In such cases, tick/crosses or thumbs up/thumbs down may help  Ask if a break or rest is needed -notice verbal and non-ve...

Systematic review on the effects of the physical and social aspects of community pharmacy spaces on service users and staff

“… 40 , 60 Pharmacists also preferred to consult in a quiet area, separate from the counter. 80 There was also accessibility problem for stroke survivors in wheelchairs and caregivers, 42 and it was recommended the consultation rooms should be larger to reduce discomfort. 109 Some viewed these spaces as undesirable if it was used by patients receiving treatment for drug problems.…”

Pharmacist prescriber smoking cessation intervention during the COVID-19 pandemic

“…However, pharmacists recognized that a hybrid approach, whereby they could see some people in person and others remotely, would mean that the service could be adapted to the particular needs of the individual. For example, a consultation with a client with hearing difficulties or communication problems, such as a stroke survivor, may be more effective face-to-face 16 . This potentially opens up smoking cessation services for a wider range of the population.…”

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

“…The concept of personcentered care has been increasingly adopted across healthcare as an attempt to focus the delivery of care around the needs of the individual in question. This extends to strokerelated services, as person-centered care and rehabilitation frameworks have been increasingly developed and implemented (21)(22)(23)(24)(25). Yet, in the UK, gaps in the wholesale integration of this approach are still evident, as care deficiencies such as: abrupt discharge, poor communication and poor followup endure (96).…”

“…In recent years, efforts have been made to better understand stroke survivors' experience of care and their transition from initial acute services to long-term support after stroke (8,19). This has seen increased attempts to embed a person-centered focus to support stroke survivors in their initial and continued rehabilitation with the intention of improving stroke survivors' adjustment (21)(22)(23)(24)(25). However, the COVID-19 pandemic has exacerbated the pre-existing disparity between acute and poststroke support, as an increase in the lack of provision of, or access to, post-stroke support has been reported (26)(27)(28); further highlighting the urgent need for new insights into how stroke survivors can be better supported by HCPs as they rebuild their lives and identities positively following stroke.…”