Mapping patients' experiences after stroke onto a patient-focused intervention framework.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland. cdonnel@tcd.ie
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Donnellan
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Martins
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Conlon
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Coughlan
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O'Neill
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Collins
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D057220:Health Literacy; D006302:Health Services Research; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D058996:Quality Improvement; D012944:Social Support; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation