Centre for Integrated Healthcare Research, School of Health in Social Science, The University of Edinburgh, Teviot Place, Edinburgh, UK.
Health Soc Care Community. 2010 Jul;18(4):424-32. doi: 10.1111/j.1365-2524.2010.00917.x. Epub 2010 May 12.
We report findings on patients with stroke and carers experiences of the healthcare system in Scotland after stroke. These findings emerged from data collected in a primary qualitative study exploring patients with stroke and carers perception of a Functional Electrical Stimulation (FES) Clinic. Rich data emerged in relation to healthcare after stroke as experienced by both patients and carers, highlighting important clinically relevant messages and constituting an important area for dissemination. Thirteen patients with stroke and nine carers consented to participate. Data were collected using face-to-face semi-structured interviews, undertaken in April and May 2007, and analysed using the framework of Interpretative Phenomenological Analysis (IPA). IPA aims to explore in depth the participants lived experiences of a specific phenomenon. An overarching theme of 'After the stroke' was identified. Within this, six sub-themes emerged entitled, (1) 'What is wrong?'; (2) 'Help came quickly'; (3) 'Something is still wrong'; (4) 'In the hospital'; (5) 'I'm taking them home' and (6) 'Back at home'. Interestingly, patients with stroke and carers recalled similar parts of the pathway through the healthcare system after stroke, resulting in the six chronological sub-themes. The data highlighted issues surrounding recognition of stroke symptoms by both participants and professionals; expeditious admission to hospital and stroke unit; consultation during the discharge planning process and access to support and community follow up. Despite the availability of clinical guidelines to direct the management of stroke, this study suggests that the experiences of patients with stroke and carers do not always concur with guideline recommendations. These results highlight that such recommendations do not always transfer into clinical practice. Both clinicians and service managers should consider these issues when delivering care to patients after stroke.
我们报告了苏格兰中风患者和护理人员对中风后医疗体系体验的研究结果。这些发现来自于一项探索中风患者和护理人员对功能性电刺激（FES）诊所感知的主要定性研究中收集的数据。这些数据主要涉及中风患者和护理人员的中风后医疗体验，突出了重要的临床相关信息，是一个重要的传播领域。共有 13 名中风患者和 9 名护理人员同意参与。数据收集采用 2007 年 4 月和 5 月进行的面对面半结构化访谈，并使用解释现象学分析（IPA）的框架进行分析。IPA 旨在深入探讨参与者对特定现象的生活体验。确定了一个总体主题“中风后”。在这一主题下，出现了六个副标题，分别是：（1）“出了什么问题？”；（2）“帮助来得很快”；（3）“仍然有问题”；（4）“在医院”；（5）“我带他们回家”；（6）“回到家”。有趣的是，中风患者和护理人员都回忆起了他们在医疗体系中经历的中风后阶段的相似部分，从而产生了这六个按时间顺序排列的副标题。这些数据突出了参与者和专业人员对中风症状的识别问题；患者迅速入院和进入中风单元；在出院计划过程中的咨询以及获得支持和社区随访的机会。尽管有临床指南指导中风的管理，但这项研究表明，中风患者和护理人员的体验并不总是符合指南建议。这些结果表明，这些建议并不总是能转化为临床实践。临床医生和服务经理在为中风患者提供护理时都应该考虑这些问题。
