Stroke patients' views on their admission to hospital

Pound, Pandora; Bury, M; Gompertz, Patrick; Ebrahim, Shah

doi:10.1136/bmj.311.6996.18

Cited by 64 publications

(56 citation statements)

References 16 publications

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“…Backe et al (1996) reported that in the first week after stroke, patients' feelings of unreality and awareness of their changed role might lead to psychological crisis. 9 In retrospective studies, patients have been reported as appreciating the hospital care they received, valuing being cared about as well as being cared for, 37 and expressing high levels of satisfaction. 38 …”

Section: Acute Carementioning

confidence: 99%

Qualitative Studies of Stroke

McKevitt

Redfern

Mold

et al. 2004

Stroke

212

204

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Background and Purpose-Qualitative studies are increasingly used to investigate social processes and phenomena influencing health behaviors and service provision. We aimed to identify the scope of published qualitative studies of stroke, consider their relevance to development and delivery of services for people with stroke, and make recommendations for future work. Methods-Literature review of published articles was identified by systematically searching online literature databases using keywords from the start of each database until 2002. Articles were reviewed by 2 authors, using a standardized matrix for data extraction. The 2003 European Stroke Initiative recommendations for stroke management were used to categorize the literature for consideration of its contribution to stroke research. Results-We included 95 articles. Their empirical contribution includes an emphasis on recording the "human" experience of stroke; identification of needs as perceived by patients and their families, differences in priorities between patients and professionals, and barriers to best-quality care. We identified 12 papers that were specifically undertaken to develop or evaluate interventions. Conclusions-Qualitative studies have addressed a wide range of issues related to the impact of stroke on individuals and caregivers, and to the organization and delivery of services. Significant problems remain in ensuring the delivery of best-quality stroke care, which such studies have the potential to address. Maximizing this potential requires greater collaboration between nonclinical and clinical scientists, service providers, and users to formulate research questions of interest as well as new research strategies, such as meta-analysis, to pool qualitative research findings and multisited investigations. Key Words: qualitative research Ⅲ caregivers Ⅲ delivery of health care Ⅲ evaluation studies Ⅲ quality of health care Ⅲ stroke T he relevance of social science research for medical practice has long been recognized. 1 Studies conducted using qualitative methods, which are drawn from the social sciences, are now commonly advocated and used in health and healthcare research. 2 The aim of qualitative research is to understand social processes and behaviors (such as responses to disease or the organization of health services) in natural rather than experimental settings, and from the perspective of participants. Specific methods used include unstructured or semistructured interviews, focus group interviews, and ethnographic observation. These methods tend to generate textual rather than numerical data, and their analysis entails identifying meanings and developing concepts, but not measuring frequency. Studies using a variety of qualitative research methods have investigated social factors that influence the delivery and uptake of a wide range of health services.Qualitative research is undertaken by researchers from a variety of disciplines, and reports may be published in journals not widely read outside the discipline concerned. The aim...

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Section: Acute Carementioning

confidence: 99%

Qualitative Studies of Stroke

McKevitt

Redfern

Mold

et al. 2004

Stroke

212

204

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“…Patients in a study of stroke services in the United Kingdom reported high levels of satisfaction with inpatient care [4]. A substantial proportion of patients and their families also reported dissatisfaction with the lack of involvement in decisions [5]. A different patient journey study in the UK [6] showed that four main themes emerged from questioning patients and their families about their in-hospital experiences; (1) information provision, (2) staff attitudes, (3) availability of care, and (4) considering the whole person in context.…”

Section: Introductionmentioning

confidence: 99%

Patient and Family Involvement: A Discussion of Co-Led Redesign of Healthcare Services

Prior¹,

Campbell²

2018

J Participat Med

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The involvement of patients and their families in the redesign of healthcare services is an important option in providing a service that addresses the patients' needs and improves health outcomes. However, it is a resource-intensive approach, and it is currently not clear when it should be used, and what should be the reasoning behind this decision. Some health systems of international standing have created a patient engagement program as a selling point. This paper discusses how co-led redesign can be beneficial in improving health service and more effectively engaging patients. Potential barriers for patient involvement are discussed. Patient involvement can be integrated into the health system at three main levels of engagement: direct care, organizational design and governance, and policy-making. The aim of this paper is to describe how co-led redesign is compatible with different levels of patient involvement and to address the challenges in delivering a co-led redesign in healthcare. Co-led redesign not only involves the collection of quantitative data for assessing the current systems but also the collection of qualitative data through patient, family, and staff interviews to determine the barriers to patient satisfaction. Co-led redesign is a resource-rich process that requires expertise in data collection and a clinical group that is devoted to implementing recommended changes. Currently, a number of countries have utilized co-led redesign for many different types of healthcare services. Resource availability and cost, process time, and lack of outcome measures are three major limiting factors.

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“…Research has found that information is considered by stroke survivors to be a vitally important component of care [35] , but in most cases individuals perceive gaps in the information they have received [36] . In other words, the DMSS Resource…”

Section: The Distress Management System For Stroke (Dmss)mentioning

confidence: 99%

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Gillespie

Cadden

2013

JNEP

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Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke.Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant barriers to the implementation of post-stroke mood and psychological distress screening programmes. One barrier relates to limitations of questionnaire methods for identifying distress. Specifically, existing mood questionnaires are often too lengthy; miss important emotional changes that result from stroke; and do not necessarily point nurses towards the most helpful intervention approaches. Methods:We sought to develop a brief, clinically valid screening system that could be used by nurses to identify the levels of psychological distress experienced by stroke survivors. As well as determining levels of distress, the system was intended to aid the identification of first-line interventions that nurses could offer to alleviate distress.Results: A screening system was identified from the oncology literature (the Distress Management System [DMS]) that appeared to meet the broad requirements for screening for stroke-related distress. To tailor the DMS for stroke settings, we obtained feedback on the components of the DMS from stroke survivors and stroke nurses, and also consulted the research literature. This led us to: (1) retain the distress screening component of the DMS, the 'Distress Thermometer'; (2) modify the DMS's 'Concerns Checklist' to reflect the main problems encountered after stroke; and (3) add a 'Resource Pack' to the screening system to enable nurses to offer first-line interventions targeted at individuals' distress. The result, the Distress Management System for Stroke (DMSS), is presented in full in this paper. Conclusion:The DMSS is a potentially useful tool for nurses working in stroke settings. It is brief, straightforward to administer, captures the main emotional concerns of stroke survivors, and the findings from the DMSS can be used to structure interventions for psychological distress. Future work is required, however, to establish the DMSS's reliability, validity and clinical effectiveness.

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Stroke patients' views on their admission to hospital

Cited by 64 publications

References 16 publications

Qualitative Studies of Stroke

Qualitative Studies of Stroke

Patient and Family Involvement: A Discussion of Co-Led Redesign of Healthcare Services

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

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