Healthcare professionals' competence in stroke care pathways: A mixed‐methods systematic review

Abstract

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.

Effects of a lifestyle counselling intervention on adherence to lifestyle changes 7 years after stroke – A quasi‐experimental study

“…The presented results strongly support the claim that nurses play a vital role in stroke care, which has been suggested in previous studies [25]. Doctors were part of the intervention planning group; however, in the future, lifestyle counselling interventions should be more tailored to a multidisciplinary team of stroke professionals [25]. This type of approach would promote both support from doctors as well as long-term adherence to treatment.…”

“…Earlier studies also suggest that certain elements of the counselling provided during the acute hospitalisation phase, such as interactions [13,21], and the resources of health-care personnel, are connected to later adherence to a healthier lifestyle [13]. The healthcare professionals who counsel stroke patients about self-management strategies need to have versatile competences [25]. Earlier research has investigated how nurseled lifestyle counselling interventions affect adherence to lifestyle changes [5,[26][27][28][29][30].…”

The Growing Importance of Mixed-Methods Research in Health

“…Similarly, a systematic review synthesised a total of 20 papers [16], and 16 papers [17] on nursing-related research paper among these only one mixedmethods paper was identified. Worse, a further two mixedmethods review recently revealed that out of 48 [18,19] synthesised nursing research papers, not one single mixedmethods paper was identified. This clearly depicts that mixedmethods research is still in its infancy stage in nursing but we can say there is huge scope to implement it to understand research questions on both sides of coin [4].…”

Effectiveness of an interventional program on nurses' knowledge concerning nursing management for patients with stroke

“…Nurses are the medical personnel that see the full impact of a stroke and should be equipped with the ability to help patients recover more quickly (Allsassmah, 2020). Jarva et al (2021) stressed the importance of multidimensional competence in nurses' work in stroke units, defining nursing competency as the mix of skills, knowledge, and attitudes required for successful or outstanding performance. In order to offer high-quality care and assist patients in achieving the best possible results, nurses in stroke care units must have relevant information, competent abilities, and a positive attitude.…”