103 New zealand hospital stroke service provision: a national survey

Thompson, Stephanie; Douwes, Jeroen; Barber, P. Alan; Cadilhac, Dominique A.; McNaughton, Harry; Gommans, John; Fink, John; Davis, Alan; Feigin, Valery; Ranta, Anna

doi:10.1136/jnnp-2019-anzan.91

Cited by 5 publications

(8 citation statements)

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“…Internationally the impact of the pandemic has also seen rehabilitation services suspended as healthcare services have been overwhelmed by patients experiencing the acute effects of COVID-19 infection (Aguiar de Sousa et al, 2020;Leira et al, 2020;Willan et al, 2020). Prior to the pandemic, audits of rehabilitation provision in New Zealand consistently highlighted delays in service provision and limitations in the amount of rehabilitation provided (McNaughton et al, 2014;Thompson et al, 2019;Yeo et al, 2016). At this stage, it is not possible to estimate the compounding effect of the COVID-19 pandemic on access to neurorehabilitation, but given what we know about the importance of rehabilitation in reducing dependence, improving health-related quality of life and carer burden, we must mitigate this impact.…”

Section: Figure 1 Telerehabilitation Methods Of Deliverymentioning

confidence: 99%

Implementation of telerehabilitation in response to COVID-19: Lessons learnt from neurorehabilitation clinical practice and education

Signal

Martin²,

Leys

et al. 2023

NZJP

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The health response to the COVID-19 pandemic has had significant impacts on neurorehabilitation provision both internationally and in New Zealand. Telerehabilitation, the delivery of rehabilitation at a distance using information and communication technologies, was advocated as a means of addressing the rehabilitation needs of our patients while maintaining physical distancing and reducing the risk of viral transmission. Despite research evidence indicating that telerehabilitation is as effective as in-person rehabilitation for people with neurological conditions, there were significant challenges in delivering and sustaining telerehabilitation practice. We draw upon our experiences in delivering telerehabilitation in neurorehabilitation clinical practice and education to reflect on the process of practice change and to consider how these experiences can inform practice development in the future. We propose that rehabilitation organisations and physiotherapists continue to develop capability to provide telerehabilitation; that physiotherapists and the physiotherapy profession focus on translating their communicative, relational and clinical skills to the digital space to ensure they are competent in telerehabilitation; and that, as a profession, we focus on what constitutes "best practice" in telerehabilitation, and how in-person and telerehabilitation can be integrated to provide engaging, evidence-based and person-centred rehabilitation.

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Section: Figure 1 Telerehabilitation Methods Of Deliverymentioning

confidence: 99%

Implementation of telerehabilitation in response to COVID-19: Lessons learnt from neurorehabilitation clinical practice and education

Signal

Martin²,

Leys

et al. 2023

NZJP

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“…After initial assessment, people may be managed locally or transferred to a tertiary hospital for specialist input. Large urban hospitals commonly have stroke‐specialist services, while nonurban care is provided by general medical teams 29 . Care is provided by multidisciplinary teams, with medical, nursing and allied health services.…”

Section: Methodsmentioning

confidence: 99%

“…All hospitals offer some form of inpatient rehabilitation, used by around one‐third of stroke patients. Community rehabilitation services may be general or stroke‐specialist; 50% are time‐limited, with people able to access services for 6 weeks to 3 months 29 . National quality indicators require transfer between services within specified time periods 30…”

Section: Methodsmentioning

confidence: 99%

‘Physical well‐being is our top priority’: Healthcare professionals' challenges in supporting psychosocial well‐being in stroke services

Bright,

Ibell‐Roberts,

Featherstone

et al. 2024

Health Expectations

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BackgroundFollowing stroke, a sense of well‐being is critical for quality of life. However, people living with stroke, and health professionals, suggest that well‐being is not sufficiently addressed within stroke services, contributing to persistent unmet needs. Knowing that systems and structures shape clinical practice, this study sought to understand how health professionals address well‐being, and to examine how the practice context influences care practice.MethodsUnderpinned by Interpretive Description methodology, we interviewed 28 health professionals across multiple disciplines working in stroke services (acute and rehabilitation) throughout New Zealand. Data were analysed using applied tension analysis.ResultsHealth professionals are managing multiple lines of work in stroke care: biomedical work of investigation, intervention and prevention; clinical work of assessment, monitoring and treatment; and moving people through service. While participants reported working to support well‐being, this could be deprioritised amidst the time‐oriented pressures of the other lines of work that were privileged within services, rendering it unsupported and invisible.ConclusionStroke care is shaped by biomedical and organisational imperatives that privilege physical recovery and patient throughput. Health professionals are not provided with the knowledge, skills, time or culture of care that enable them to privilege well‐being within their work. This has implications for the well‐being of people with stroke, and the well‐being of health professionals. In making these discourses and culture visible, and tracing how these impact on clinical practice, we hope to provide insight into why well‐being work remains other to the ‘core’ work of stroke, and what needs to be considered if stroke services are to better support people's well‐being.Patient or Public ContributionsPeople with stroke, family members and people who provide support to people with stroke, and health professionals set priorities for this research. They advised on study conduct and have provided feedback on wider findings from the research.

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“…Second, South Asians are a fast-growing ethnic group in multiple high-income countries, including the USA, UK and Canada 53–56. Third, implementing culturally appropriate stroke services is a priority among many high-income countries 57–61. Fourth, differences in poststroke incidence and outcomes between White and ethnic groups are noted in several high-income countries 32 62–64.…”

Section: Methods and Analysismentioning

confidence: 99%

Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol

et al. 2022

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IntroductionSouth Asian groups experience a higher burden of stroke and poorer functional outcomes after stroke than their White counterparts. However, within the stroke literature, there has been little focus on the unique poststroke needs of the South Asian community and opportunities for community-based services to address these needs.Research questionWhat is the current knowledge base related to the experiences and needs, including unmet needs of people living with stroke and their caregivers from South Asian communities living in high-income countries?AimsThis is a protocol for a review that intends to synthesise existing studies of the poststroke experiences and needs of individuals from South Asian communities to uncover opportunities for community-based resources to address these needs.Methods and analysisThis scoping review methodology will be guided by modified Arksey and O’Malley (2005) and Joanna Briggs Institute frameworks. A search on OVID Medline, OVID Embase, OVID PsycINFO, EBSCO CINAHL, the Cochrane Library, Scopus and Global Index Medicus will be conducted to synthesise existing peer-reviewed literature (all study designs). Grey literature will be searched through detailed hand searching. Literature focusing on the poststroke experiences and needs of South Asian groups impacted by stroke residing in high-income countries will be included. Study descriptors will be extracted (eg, study location, type, methodology). Data will be analysed descriptively and thematically. Team meetings will provide opportunities for peer debriefing, thereby enhancing analytic rigour.Conclusion and implicationsFindings will enhance knowledge of the poststroke experiences and needs of South Asian communities living in high-income countries and identify actionable opportunities for community-based resources to address needs.Ethics and disseminationEthics approval was not required for this scoping review protocol. Community-based organisations will be consulted to provide insights into the analysis and assist with dissemination. Dissemination of findings will also occur through a publication and academic presentations.

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103 New zealand hospital stroke service provision: a national survey

Cited by 5 publications

References 0 publications

Implementation of telerehabilitation in response to COVID-19: Lessons learnt from neurorehabilitation clinical practice and education

Implementation of telerehabilitation in response to COVID-19: Lessons learnt from neurorehabilitation clinical practice and education

‘Physical well‐being is our top priority’: Healthcare professionals' challenges in supporting psychosocial well‐being in stroke services

Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol

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