School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
Disabil Rehabil. 2013 Mar;35(6):483-91. doi: 10.3109/09638288.2012.702844. Epub 2012 Aug 14.
Stroke patients' involvement in the rehabilitation process including decision making has made significant advances clinically over the past two decades. However, development of patient-focused interventions in stroke rehabilitation is a relatively under developed area of research. The aim of this study was to interpret the explanations that patients gave of their experience after stroke and how these may validate an already established patient-focused intervention framework - the Quest for quality and improved performance (QQUIP) (2006) that includes seven quality improvement goals.
A random purposive sample of eight stroke patients was interviewed between 3 and 6 months following discharge. Patients' reports of their experience after stroke were obtained using in-dept semi-structured interviews and analysed using Qualitative Content Analysis.
Explanations given by patients included both positive and negative reports of the stroke experience. Regardless of consequences as a result of physical, psychological and social impairments, there were other life style disruptions that were reported by all patients such as taking new medication and adverse effects of these, experiencing increasing fatigue, difficulties with social activities and situations and having to make changes in health behaviours and lifestyle. Some of the core themes that emerged reflected the aims of QQUIP improvement goals that include improving health literacy, clinical decision-making, self-care, patient safety, access to health advice, care experience and service development.
Further recommendations based on the findings from this study would be to consider using the QQUIP framework for developing intervention studies in stroke rehabilitation care that are person-centred. This framework provides a template that is equipped to address some of the main concerns that people have following the experience of stroke and also focuses on improving quality of care.
在过去的二十年中，中风患者参与康复过程，包括决策，在临床方面取得了重大进展。然而，中风康复中以患者为中心的干预措施的发展是一个相对未充分发展的研究领域。本研究的目的是解释中风后患者对自己经历的解释，以及这些解释如何验证已经建立的以患者为中心的干预框架——追求质量和提高绩效（QQUIP）（2006 年），该框架包括七个质量改进目标。
在出院后 3 至 6 个月期间，对 8 名中风患者进行了随机目的抽样采访。使用深入的半结构化访谈获取患者中风后经历的报告，并使用定性内容分析进行分析。
患者的解释包括对中风经历的积极和消极报告。无论身体、心理和社会损伤的后果如何，所有患者都报告了其他生活方式的中断，例如服用新的药物和这些药物的不良反应、经历越来越多的疲劳、社会活动和情况的困难以及不得不改变健康行为和生活方式。出现的一些核心主题反映了 QQUIP 改进目标的目标，包括提高健康素养、临床决策、自我护理、患者安全、获得健康建议、护理体验和服务发展。
基于本研究的结果，进一步的建议是考虑在中风康复护理中使用 QQUIP 框架来开发以人为中心的干预研究。该框架提供了一个模板，能够解决人们在经历中风后主要关注的问题，并侧重于提高护理质量。
