VOICES: the value of 6-month clinical evaluation in stroke. The protocol for a planned qualitative study to ascertain the value of stroke follow-up to people affected by stroke

Abstract

IntroductionThe National Clinical Guidelines for Stroke recommend ‘routine follow-up of patients 6 months post discharge’. The Sentinel Stroke National Audit Programme sets a standard of 6 months postadmission follow-up, capturing data on process and outcomes. There appears to be no convincing model of stroke follow-up at 6 months, and despite evidence of unmet need in almost 50% of stroke survivors 1–5 years after their stroke, little work focuses on the first 12 months of recovery. By listening to the living experiences of stroke, the research aims to tailor the stroke care pathway to the needs of those affected.Methods and analysisA focus group of six stroke survivors and carers will be invited to identify appropriate interview questions about the value of follow-up at 6 months, ensuring that this study has its genesis in the participant experience. A pilot study of four stroke survivors will ascertain the feasibility of the method. Thirty stroke survivors from the follow-up clinic will be invited to take part in semistructured interviews. Raw data, in the form of digital recordings of the interviews, will be transcribed. Interview transcriptions will be checked by the participant for accuracy prior to analysis using NVivo software. Literal and reflective narrative analysis will be used to code transcribed text to examine shared themes and reflect on content.Ethics and disseminationStudy documentation has been reviewed by the Coventry and Warwickshire Research Ethics Committee; the chief investigator met with the committee to scrutinise the study and justify its methodology. The committee has approved this study. A copy of the final report will be given to participants, the Stroke Association, the local Clinical Commissioning Group and participants’ general practitioners. It is intended to disseminate the results locally by presentation to the Trust board, at academic conferences and by publication in a peer-reviewed scientific journal.

Doctor’s follow-up after stroke in the south of Sweden: An observational study from the Swedish stroke register (Riksstroke)

“…36 The value of the six-month followup is currently under study. 37 The patients' perspective on stroke follow-up was assessed in a Swedish qualitative study where half of the study subjects were dissatisfied with the care provided from their general practitioner after stroke. Some did not understand that they had had a follow-up visit after hospitalization, and some were dissatisfied with having to organize follow-up themselves.…”

Acute stroke awareness of family physicians: translation of policy to practice

“…NVIVO was used to visualize qualitative data to support understanding. Formerly, others have also used narrative analysis in the stroke care setting as this method allows the assessment of language use, interpretation and reflexion regarding the content [ 18 , 19 ]. Synonyms were collated and expletives and conjunctions were omitted.…”

Critical points in the experience of spouse caregivers of patients who have suffered a stroke. A phenomenological interpretive study

“…The following population inclusion criteria were considered: spouses of patients who suffered a stroke and survived, spouses who undertook the role of main caregiver for more than 6 months after discharge [ 5 ], and spouses who voluntarily agreed to take part in the study. It was considered that 6 months after discharge would be enough time for caregivers to reflect about their caring experience providing information about their transition along the caring process [ 30 , 31 ]. Purposive sampling considered the spouse age, length of caregiving time and stroke survivors’ acquired incapacity aiming to select a sample that comprised heterogeneous profiles [ 32 ].…”