Tunkl Christine, Paudel Raju, Thapa Lekhjung, Shreyan Shirsho, Krauss Alexandra, Subedi Ashim, Karmacharya Balgopal, Jalan Pankaj, Begli Nima Haji, Tunkl Patrick, Bajaj Sunanjay, Kosinski Andrea, Kosinski Christoph, Ghimire Pradesh, Shah Bhupendra, Chandra Avinash, Ghimire Mahesh Raj, Prasad Gajurel Bikram, Golenia Jessica, van der Merwe Jan, Stang Christina, Sedani Rupal, Gumbinger Christoph
Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
Grande International Hospital, Kathmandu, Nepal.
Front Neurol. 2025 Aug 7;16:1562948. doi: 10.3389/fneur.2025.1562948. eCollection 2025.
The Nepal Stroke Project (NSP) aims to improve stroke care in a resource-limited setting. This qualitative study explores healthcare professionals' experiences and perceptions of barriers and success factors in implementing stroke care in Nepal.
Semi-structured interviews were conducted with eight healthcare professionals (six physicians, two nurses) involved in the NSP. Interviews were analyzed using qualitative content analysis, following a constructivist approach.
Success factors encompassed the dedication of healthcare professionals, involvement of hospital boards, effective training initiatives, and the formation of stroke teams. Positive developments noted were increased thrombolysis availability, improved stroke awareness, and growing interest in stroke care among medical professionals. Key barriers identified included lack of government ownership in stroke care advocacy, financial constraints for patients, inadequate public awareness, and challenges in implementing quality monitoring.
While the NSP has initiated positive changes in Nepal's stroke care landscape, significant barriers persist. The study highlights the importance of addressing systemic issues such as government involvement and financial accessibility of treatments. Success factors, particularly the motivation of healthcare professionals and local ownership of the project, provide a foundation for future improvements. These findings can inform strategies for enhancing stroke care delivery in other resource-limited settings and guide ongoing initiatives within the NSP.
尼泊尔中风项目（NSP）旨在改善资源有限环境下的中风护理。这项定性研究探讨了医疗保健专业人员在尼泊尔实施中风护理过程中的经历以及对障碍和成功因素的看法。
对参与尼泊尔中风项目的八名医疗保健专业人员（六名医生、两名护士）进行了半结构化访谈。采用建构主义方法，运用定性内容分析法对访谈进行分析。
成功因素包括医疗保健专业人员的奉献精神、医院董事会的参与、有效的培训举措以及中风团队的组建。注意到的积极进展包括溶栓治疗的可及性增加、中风意识提高以及医学专业人员对中风护理的兴趣日益浓厚。确定的主要障碍包括政府在中风护理宣传方面缺乏主导权、患者的经济限制、公众意识不足以及实施质量监测方面的挑战。
虽然尼泊尔中风项目已在尼泊尔的中风护理领域引发了积极变化，但重大障碍依然存在。该研究强调了解决系统性问题（如政府参与和治疗费用可及性）的重要性。成功因素，特别是医疗保健专业人员的积极性和项目的地方主导权，为未来的改进奠定了基础。这些研究结果可为在其他资源有限环境中加强中风护理服务的策略提供参考，并指导尼泊尔中风项目内的现行举措。
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