Person-centred care in individuals with stroke: a qualitative study using in-depth interviews

Abstract

Background Person-centred care (PCC) has considerable effects on the clinical practice of health professionals. The purpose of this study was to describe the perspectives and perceived barriers and enablers of individuals with stroke regarding the PCC model in stroke rehabilitation. Methods A qualitative exploratory study was conducted based on an interpretive framework. Participants were recruited using non-probabilistic purposeful sampling and a snowball-technique strategy. The inclusion criteria consisted of: (a) individuals > 18 years, (b) diagnosed with moderate or severe stroke according to the National Institutes of Health Stroke Scale and (c) in the post-acute or chronic stage of the disease. In total, 31 individuals with stroke were included. In-depth interviews and researchers’ field notes were used to collect the data. A thematic analysis was performed. Also, credibility, transferability, dependability and confirmability techniques were followed to establish trustworthiness of the data. Results Thirty-one individuals with stroke (11 women) were included. Three main themes were identified: (a) The person behind the “patient” label, recognizing the person beyond their illness and valuing their identity and individual characteristics, (b) The person at the centre of care, considering themselves as an active agent in their own care and respecting their preferences and expectations for their care process and (c) Training for PCC, providing health professionals with tools to achieve professional skills for the implementation and development of the PCC model. Conclusions and significance This paper describes relevant aspects that health professionals should consider when providing PCC in the context of the rehabilitation of individuals with stroke. Key messages The individuals’ perspective regarding person-centred care (PCC) has considerable effects on the clinical practice of health professionals. Individuals with stroke describe how there is a person behind the "patient" label, with identity, needs and desire to participate in decision making. Training in the PCC model helps healthcare professionals identify the needs of individuals with stroke during rehabilitation.

Exemplary post-discharge stroke rehabilitation programs: A multiple case study

“…Increasingly, the ability to provide respectful personalized care, and to build and maintain a therapeutic alliance, is recognized as essential to effective rehabilitation. 21 , 22 Our study added support to emerging findings regarding the importance of person-centered care in neurorehabilitation. There have been increasing calls to better characterize what such care looks like in practice.…”

Supportive care needs of patients who had a stroke: a scoping review protocol

“… 2 3 It is essential to identify the supportive care needs (SCNs) and provide person-centred care for the rehabilitation and rebuilding of individuals with stroke. 4 Previous studies have confirmed that stroke survivors live with a wide range of physical, 3 psychological, emotional, practical issues, 5 experience disease uncertainty 6 and at a high risk of developing depression, especially in those who have poststroke aphasia. 7 Unmet SCNs of patients who had a stroke will not only decrease their quality of life but also affect their health outcomes negatively.…”

“…Most stroke survivors are discharged from the hospital to the community with varying degrees of residual neurological deficits 2 3. It is essential to identify the supportive care needs (SCNs) and provide person-centred care for the rehabilitation and rebuilding of individuals with stroke 4. Previous studies have confirmed that stroke survivors live with a wide range of physical,3 psychological, emotional, practical issues,5 experience disease uncertainty6 and at a high risk of developing depression, especially in those who have poststroke aphasia 7.…”

Built Environments to Support Rehabilitation for People With Stroke From the Hospital to the Home (B-Sure): Protocol for a Mixed Method Participatory Co-Design Study

“…The effects of stroke can be profound and lead to a range of activity and participation limitations [9][10][11], such as reduced quality of life, social isolation [12][13][14], and adverse events such as falls [9,15]. Many patients and families describe the support provided poststroke as poor and not patient-centered [16][17][18] and report poor engagement in their care and treatment decisions [7,19]. In addition, the role and importance played by the built environment to support rehabilitation outcomes have been largely ignored, especially when patients return home [20,21].…”