Expanding the role of practical nurses to provide both preventive and rehabilitation guidance should be seen as an important strategy in health care. Individual needs, gender differences and support from families and peers should be taken into consideration when planning and implementing guidance.
Background
The challenges of caring for stroke patients are growing due to population ageing and improved survival rates. Healthcare professionals' competence development in stroke care is a necessity to ensure high‐quality patient care.
Objectives
To identify and describe the competence areas of healthcare professionals working in the stroke patient care pathway and factors influencing these competences.
Design
A mixed‐methods systematic review.
Methods
The review was conducted according to the JBI guidelines and registered in the PROSPERO database (CRD42020204062). PRISMA checklist guided the review process. Relevant original studies were identified by searching four databases—CINAHL (EBSCO), PubMed, Scopus and Medic. After researcher consensus was reached, 32 studies were selected for inclusion and subjected to content analysis and data tabulation.
Results
Competence in care processes, clinical competence, competence in using self‐management strategies, interaction skills, skills in acknowledging family and competence in integrating the available evidence base into patient care were identified as key competence areas. Organisation of services, specialisation in stroke care, continuous development and education, family and carer and training in oral care and cognitive rehabilitation were identified as factors that influence healthcare professionals' competence.
Conclusions
Diverse clinical and interaction competencies are needed throughout the stroke care pathway, and various factors affect healthcare professionals' competence. Further research on healthcare professionals' stroke care competence will be needed to respond to changing healthcare demand.
Relevance to clinical practice
We recommend organisational support and formulation of stroke care patient guidelines in line with healthcare competence requirements. Focus should be added for nursing professions in developing interactive communication competence since nurses spend the majority of the time providing individual patient care. Also, organisations should integrate continuing training in specialised stroke care for healthcare professionals' competence development.
Citizens are ready and willing to use various kinds of e-health services and Web-based portals. The purpose of this study was to describe the experiences of patients who underwent an arrhythmia procedure of the guidance they received as well as their needs and expectations for a future digital care path. The goal for the future is to utilize the results in other patient-centered digital service development activities. The research material was collected in a two-part thematic interview with patients who underwent an electrophysiology examination and supraventricular tachycardia catheter ablation procedure (n=7) or ablation treatment for atrial fibrillation (n=4). The preliminary digital care path was modified based on the results. The arrhythmia patient’s digital care path was tested in a workshop using a test group consisting of patients (n=3) and nursing staff (n=6). As a result, a digital care pathway for arrhythmia patients was completed.
Deterioration of any clinical characteristics or HRQoL was not observed after any of the treatment modalities. Surgery gave LLAD patients a good clinical outcome and HRQoL for at least a year, whereas patients who were treated with endovascular and especially conservative treatment gained limited benefits.
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