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Br J Gen Pract. Feb 2003; 53(487): 137–142.
PMCID: PMC1314515

Developing a primary care-based stroke service: a review of the qualitative literature.

Abstract

The aim of this review was to identify the most frequently encountered longer-term problems experienced by stroke patients and their informal carers. Systematically identified qualitative studies describing self-reported experiences of stroke-related long-term problems were independently reviewed and the findings analysed using a clustering technique. Twenty-three qualitative studies, which included approximately 500 patients and 180 carers, were identified by the search methods. Most of the studies were cross-sectional, United Kingdom-based, and employed semi-structured individual interviews. The review identified 203 problem areas, which were categorised into five domains: hospital experience; transfer of care; communication; services; and social and emotional consequences. The largest domain was the social and emotional consequences of stroke, representing 39% of all problem areas. These included problems relating to mood, social changes, attitudes to recovery, and changes in self-perception and relationships. Service deficiencies, encompassing both health and social care, was the second largest domain, accounting for 29% of the problem areas. The review provides a basis for a user-focused, longer-term stroke service. The need for responses that go beyond the traditional physical rehabilitation approach is evident, and research to identify broader treatment strategies is now required.

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Selected References

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  • Young JB. The primary care stroke gap. Br J Gen Pract. 2001 Oct;51(471):787–788. [PMC free article] [PubMed]
  • Field D, Cordle CJ, Bowman GS. Coping with stroke at home. Int Rehabil Med. 1983;5(2):96–100. [PubMed]
  • Mumma CM. Perceived losses following stroke. Rehabil Nurs. 1986 May-Jun;11(3):19–24. [PubMed]
  • Greveson G, James O. Improving long-term outcome after stroke--the views of patients and carers. Health Trends. 1991;23(4):161–162. [PubMed]
  • McLean J, Roper-Hall A, Mayer P, Main A. Service needs of stroke survivors and their informal carers: a pilot study. J Adv Nurs. 1991 May;16(5):559–564. [PubMed]
  • Doolittle ND. The experience of recovery following lacunar stroke. Rehabil Nurs. 1992 May-Jun;17(3):122–125. [PubMed]
  • Brandriet LM, Lyons M, Bentley J. Perceived needs of poststroke elders following termination of home health services. Nurs Health Care. 1994 Dec;15(10):514–520. [PubMed]
  • Grant JS. Home care problems experienced by stroke survivors and their family caregivers. Home Healthc Nurse. 1996 Nov;14(11):892–902. [PubMed]
  • Dowswell G, Lawler J, Young J, Forster A, Hearn J. A qualitative study of specialist nurse support for stroke patients and care-givers at home. Clin Rehabil. 1997 Nov;11(4):293–301. [PubMed]
  • Brotheridge S, Young J, Dowswell G, Lawler J, Forster A. A preliminary investigation of patient and carer expectations of their general practitioner in longer-term stroke care. J Eval Clin Pract. 1998 Aug;4(3):237–241. [PubMed]
  • Pound P, Gompertz P, Ebrahim S. A patient-centred study of the consequences of stroke. Clin Rehabil. 1998 Aug;12(4):338–347. [PubMed]
  • Wiles R, Pain H, Buckland S, McLellan L. Providing appropriate information to patients and carers following a stroke. J Adv Nurs. 1998 Oct;28(4):794–801. [PubMed]
  • Perry SI, Hsu RT, Brooks W, Cherry D. Perceptions of community services among Asian and white stroke survivors and their carers: an exploratory study. Ethn Health. 1999 Feb-May;4(1-2):101–105. [PubMed]
  • Lawler J, Dowswell G, Hearn J, Forster A, Young J. Recovering from stroke: a qualitative investigation of the role of goal setting in late stroke recovery. J Adv Nurs. 1999 Aug;30(2):401–409. [PubMed]
  • Brereton L, Nolan M. 'You do know he's had a stroke, don't you?' Preparation for family care-giving--the neglected dimension. J Clin Nurs. 2000 Jul;9(4):498–506. [PubMed]
  • Sabari JS, Meisler J, Silver E. Reflections upon rehabilitation by members of a community based stroke club. Disabil Rehabil. 2000 May 10;22(7):330–336. [PubMed]
  • Burton CR. Living with stroke: a phenomenological study. J Adv Nurs. 2000 Aug;32(2):301–309. [PubMed]
  • Dowswell G, Lawler J, Dowswell T, Young J, Forster A, Hearn J. Investigating recovery from stroke: a qualitative study. J Clin Nurs. 2000 Jul;9(4):507–515. [PubMed]
  • Popay J, Rogers A, Williams G. Rationale and standards for the systematic review of qualitative literature in health services research. Qual Health Res. 1998 May;8(3):341–351. [PubMed]
  • Forster A, Young J. Specialist nurse support for patients with stroke in the community: a randomised controlled trial. BMJ. 1996 Jun 29;312(7047):1642–1646. [PMC free article] [PubMed]

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