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Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design
Emma K Kjörk1, Gunnel Carlsson1, Katharina S Sunnerhagen1
1Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg.
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.
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