Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions – A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden

Abstract

Introduction: Care transitions are a complex set of actions that risk poor quality outcomes for patients and their significant others. This study explored the transition process between hospital and continued rehabilitation in the home. The process is explored from the perspectives of people with stroke, significant others and healthcare professionals in Stockholm, Sweden. Method: Focus group interviews (n = 10), semi-structured individual interviews (n = 23) and interviews in dyad (n = 4) were conducted with healthcare professionals, people with stroke and significant others, altogether 71 participants. Data was collected and analyzed using Grounded Theory. Results: One core category "Perceptive dialogue for a coordinated transition", and two categories "Synthesis of parallel processes for common understanding" and "The forced transformation from passive attendant to uninformed agent" emerged from the analysis. The transition consisted of several parallel processes which made it difficult for the stakeholders to get a common understanding of the transition as a whole. Enabling a perceptive dialogue was as a prerequisite for the creation of a common understanding of the care transition. Conclusion: This study elucidates that a perceptive dialogue with patients/significant others as well as within and across organizations is part of a coordinated and person-centred transition. There is an extensive need for increased involvement of patients and significant others regarding dialogue about health conditions, procedures at the hospital and preparation for self-management after discharge.

The manifestation of participation within a co‐design process involving patients, significant others and health‐care professionals

“…Due to the low number of significant others reporting their interest to participate, contacts were made with significant others from a previous study on experiences of care transitions. 27 Out of three significant others approached in this way, two declined and one agreed to participate. Oral and written information about the study was provided.…”

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

“…The overall burden of stroke is considerable and continues to increase in the context of an ageing population (GBD, 2016Stroke Collaborators, 2019. Most stroke survivors are discharged to home, and the hospital-to-home transition poses many challenges for them and family caregivers to manage care at home whilst engaging in rehabilitation and recovery (Lindblom et al, 2020;Reeves et al, 2019). These challenges have become more prominent in the context of shortened hospital stays and early discharge by which stroke patients and their caregivers take charge of care activities and coordinate care services instead of health professionals in hospital (Camicia et al, 2016;Chen et al, 2020).…”

Continuity of Care and Self-Management among Patients with Stroke: A Cross-Sectional Study

“…Moreover, this study found that there was better self-management among patients with better COC, which is consistent with the results of other qualitative research. Lack of disease care-related information during hospitalization and failure to establish relationships and communication between healthcare personnel and patients could hinder the latter's implementation of self-management [41]. Therefore, medical teams must ensure and strengthen the COC among patients during hospitalization in order to convey sufficient personal health information and provide appropriate care according to patients' individuality to improve self-management [42,43].…”