title: Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors.
abstract: OBJECTIVE
  Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge.
  
  
  METHODS
  This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups.
  
  
  METHODS
  Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK.
  
  
  METHODS
  41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups.
  
  
  RESULTS
  Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups.
  
  
  CONCLUSIONS
  Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers' part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face.
authors.affiliation: Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK.
authors.forename: Nan
authors.initials: N
authors.lastname: Greenwood
authors.affiliation: Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK.
authors.forename: Jess
authors.initials: J
authors.lastname: Holley
authors.affiliation: Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK.
authors.forename: Theresa
authors.initials: T
authors.lastname: Ellmers
authors.affiliation: Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Mein
authors.affiliation: Department of Neurology, St George's Healthcare NHS Trust, London, UK.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Cloud
mesh_terms: D000368:Aged; D044466:Asian People; D044383:Black People; D017028:Caregivers; D003469:Culture; D006233:Persons with Disabilities; D005006:Ethnicity; D005190:Family; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D008131:London; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D010351:Patient Discharge; D036301:Qualitative Research; D012944:Social Support; D012947:Social Work; D020521:Stroke / Q000150:complications / Q000451:nursing; D017741:Survivors; D044465:White People
keywords: QUALITATIVE RESEARCH
references.citation: Disabil Rehabil. 2014;36(3):185-98
references.pmid: 23597001
references.citation: J Gerontol B Psychol Sci Soc Sci. 2002 Jul;57(4):S221-33
references.pmid: 12084792
references.citation: Stroke. 2005 Mar;36(3):639-43
references.pmid: 15677575
references.citation: J Gerontol Soc Work. 2006;47(1-2):133-56
references.pmid: 16901881
references.citation: Disabil Rehabil. 2011;33(19-20):1890-900
references.pmid: 21314290
references.citation: Int J Geriatr Psychiatry. 2005 Jun;20(6):537-46
references.pmid: 15920707
references.citation: Int J Nurs Stud. 2014 Mar;51(3):418-29
references.pmid: 23928324
references.citation: Disabil Rehabil. 2012;34(17):1413-22
references.pmid: 22309576
references.citation: BMC Med Res Methodol. 2014 Sep 20;14:107
references.pmid: 25240807
references.citation: Disabil Rehabil. 2009;31(5):337-51
references.pmid: 18608402
references.citation: Health Soc Care Community. 2015 Jan;23(1):64-78
references.pmid: 25135207
references.citation: Clin Rehabil. 2000 Aug;14(4):381-92
references.pmid: 10945422
references.citation: Disabil Rehabil. 2007 Jan 30;29(2):111-21
references.pmid: 17364762
references.citation: Res Nurs Health. 1997 Feb;20(1):27-37
references.pmid: 9024475
references.citation: BMJ. 2000 Jan 8;320(7227):114-6
references.pmid: 10625273
references.citation: Disabil Rehabil. 2008;30(18):1329-49
references.pmid: 19230230
references.citation: Maturitas. 2010 Jul;66(3):268-76
references.pmid: 20430542
references.citation: Int J Nurs Stud. 2009 Sep;46(9):1194-200
references.pmid: 19303597
references.citation: J Adv Nurs. 2005 Sep;51(6):549-57
references.pmid: 16129005
references.citation: Soc Sci Med. 2002 Oct;55(7):1255-66
references.pmid: 12365535
references.citation: Gerontologist. 2005 Apr;45(2):177-85
references.pmid: 15799982
references.citation: Br J Psychiatry. 2008 Sep;193(3):240-6
references.pmid: 18757985
references.citation: J Clin Nurs. 2010 Jul;19(13-14):2057-64
references.pmid: 20920032
references.citation: Circulation. 2007 Nov 6;116(19):2157-64
references.pmid: 17967776