使用清单来促进中风后长期护理需求的管理：来自焦点小组和可行性研究的见解。
Using a checklist to facilitate management of long-term care needs after stroke: insights from focus groups and a feasibility study.
机构信息
Institute for Applied Health Research, University of Birmingham, Birmingham, Edgbaston, B15 2TT, UK.
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts' Causeway, Cambridge, CB1 8RN, UK.
出版信息
BMC Fam Pract. 2019 Jan 4;20(1):2. doi: 10.1186/s12875-018-0894-3.
BACKGROUND
Long-term needs of stroke survivors are often not adequately addressed and many patients are dissatisfied with care post-discharge from hospital. Primary care could play an important role in identifying need in people with stroke.
AIM
We aimed to explore, refine and test the feasibility and acceptability of a post-stroke checklist for stroke reviews in primary care.
DESIGN AND SETTING
Focus groups (using a generic qualitative approach) and a single-centre feasibility study.
METHOD
Five focus groups were conducted; three with healthcare providers and two with stroke survivors/carers. The focus groups discussed acceptability of a checklist approach and the content of an existing checklist. The checklist was then modified and piloted in one general practice surgery in the East of England.
RESULTS
The qualitative data found the concept of a checklist was considered valuable to standardise stroke reviews and prevent post-stroke problems being missed. Items were identified that were missing from the original checklist: return to work, fatigue, intimate relationships and social activities. Time constraints was the main concern from healthcare professionals and pre-completion of the checklist was suggested to address this. Thirteen stroke survivors were recruited to the feasibility study. The modified checklist was found to be feasible and acceptable to patients and primary care clinicians and resulted in agreed action plans.
CONCLUSION
The modified post-stroke checklist is a pragmatic and feasible approach to identify problems post-stroke and facilitate referral to appropriate support services. The checklist is a potentially valuable tool to structure stroke reviews using a patient-centred approach.
背景
中风幸存者的长期需求往往得不到充分满足，许多患者对出院后的护理不满意。初级保健在识别中风患者的需求方面可以发挥重要作用。
目的
我们旨在探索、完善和测试在初级保健中进行中风复查的中风后检查表的可行性和可接受性。
设计和设置
焦点小组（使用通用定性方法）和单中心可行性研究。
方法
进行了五次焦点小组讨论；其中三次是与医疗保健提供者进行的，另外两次是与中风幸存者/照顾者进行的。焦点小组讨论了检查表方法的可接受性以及现有检查表的内容。然后对检查表进行了修改，并在英格兰东部的一家普通外科手术中进行了试点。
结果
定性数据分析发现，检查表的概念被认为对标准化中风复查和防止遗漏中风后问题很有价值。确定了原始检查表中缺失的项目：重返工作、疲劳、亲密关系和社交活动。时间限制是医疗保健专业人员的主要关注点，并建议预先填写检查表来解决这个问题。有 13 名中风幸存者被纳入可行性研究。修改后的检查表被发现对患者和初级保健临床医生来说是可行和可接受的，并制定了商定的行动计划。
结论
修改后的中风后检查表是一种实用且可行的方法，可以确定中风后的问题，并促进向适当的支持服务转介。检查表是一种以患者为中心的方法来组织中风复查的潜在有价值的工具。
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