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Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design
  1. Emma K Kjörk,
  2. Gunnel Carlsson,
  3. Katharina S Sunnerhagen,
  4. Åsa Lundgren-Nilsson
  1. Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg
  1. Correspondence to Mrs Emma K Kjörk; emma.kjork{at}neuro.gu.se

Abstract

Objective The wide range of outcomes after stroke emphasises the need for comprehensive long-term follow-up. The aim was to evaluate how people with stroke and health professionals (HPs) perceive the use of the poststroke checklist (PSC), with a focus on feasibility and relevance.

Design An exploratory design with a mix of qualitative and quantitative methods.

Setting Outpatient care at a university hospital and primary care centres in western Sweden.

Participants Forty-six consecutive patients (median age, 70; range, 41–85; 13 women) and 10 health professionals (median age 46; range, 35–63; 7 women).

Results Most patients (87%) had one or more problems identified by the PSC. The most common problem areas were life after stroke (61%), cognition (56%), mood (41%) and activities of daily living (39%). Three organisational themes emerged from the focus group discussions. The perception of the content and relevance of the PSC was that common poststroke problems were covered but that unmet needs still could be missed. Identifying needs was facilitated when using the PSC as a tool for dialogue. The dialogue between the patient and HP as well as HPs stroke expertise was perceived as important. The PSC was seen as a systematic routine and a base for egalitarian follow-up, but participants stressed consideration given to each individual. Addressing identified needs and meeting patient expectations were described as challenging given available healthcare services.

Conclusions The PSC is a feasible and relevant tool to support egalitarian follow-up and identify patients who could benefit from targeted poststroke interventions. Stroke expertise, room for dialogue and caring for identified needs emerged as important issues to consider when using the PSC. Nutrition, sexuality and fatigue were areas mentioned that might need to be addressed within the discussions. The PSC can facilitate patients in expressing their needs, enhancing their ability to participate in decision-making.

  • long-term care
  • feasibility
  • focus groups
  • follow-up
  • standard of care
  • stroke

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Footnotes

  • Contributors EKK, ÅL-N and KSS contributed to the design of the study. EKK conducted the interviews and analysed the data together with GC, involving KSS and ÅL-N in the final stages of the analysis. EKK wrote the first version of the manuscript, which was reviewed by GC, ÅL-N KSS. All four authors contributed to and approved the final manuscript.

  • Funding The study was funded in part by the Swedish Stroke Association; the Local Research and Development Board for Gothenburg and Södra Bohuslän; the Swedish Heart and Lung Foundation; the Swedish Brain Foundation; an unconditional grant from Allergan; the Hjalmar Svenssons Foundation; Neurological Foundation; Greta and Einar Askers Foundation; Rune and Ulla Amlövs Foundation; Per-Olof Ahls Foundation and John and Brit Wennerströms Foundation. The study was supported by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (ALFGBG-719 80).

  • Competing interests None declared.

  • Ethics approval The regional ethical review board in Gothenburg approved the study (no. 521–14).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Due to ethical restrictions, data are available on request. Researchers can submit requests for data to the authors (contact: ks.sunnerhagen@neuro.gu.se). Complete data from interviews cannot be made publicly available for ethical and legal reasons, according to the Swedish regulations http://www.epn.se/en/start/regulations/. Public availability would compromise participant privacy or confidentiality. On request, a list of condensed meaning units or codes can be made available after removal of information that may risk the confidentiality of the participants. To access data, please contact the first author: (emma.kjork@neuro.gu.se).

  • Patient consent for publication Not required.

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