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. 2003 Feb;53(487):137–142.

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

Jenni Murray 1, Robert Ashworth 1, Anne Forster 1, John Young 1
PMCID: PMC1314515  PMID: 12817361

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

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brandriet L. M., 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] [Google Scholar]
  2. 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. doi: 10.1046/j.1365-2702.2000.00396.x. [DOI] [PubMed] [Google Scholar]
  3. 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. doi: 10.1046/j.1365-2753.1998.00007.x. [DOI] [PubMed] [Google Scholar]
  4. Burton C. R. Living with stroke: a phenomenological study. J Adv Nurs. 2000 Aug;32(2):301–309. doi: 10.1046/j.1365-2648.2000.01477.x. [DOI] [PubMed] [Google Scholar]
  5. Doolittle N. D. The experience of recovery following lacunar stroke. Rehabil Nurs. 1992 May-Jun;17(3):122–125. doi: 10.1002/j.2048-7940.1992.tb01528.x. [DOI] [PubMed] [Google Scholar]
  6. 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. doi: 10.1046/j.1365-2702.2000.00411.x. [DOI] [PubMed] [Google Scholar]
  7. 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. doi: 10.1177/026921559701100405. [DOI] [PubMed] [Google Scholar]
  8. Field D., Cordle C. J., Bowman G. S. Coping with stroke at home. Int Rehabil Med. 1983;5(2):96–100. doi: 10.3109/03790798309166872. [DOI] [PubMed] [Google Scholar]
  9. 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. doi: 10.1136/bmj.312.7047.1642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Grant J. S. Home care problems experienced by stroke survivors and their family caregivers. Home Healthc Nurse. 1996 Nov;14(11):892–902. doi: 10.1097/00004045-199611000-00008. [DOI] [PubMed] [Google Scholar]
  11. Greveson G., James O. Improving long-term outcome after stroke--the views of patients and carers. Health Trends. 1991;23(4):161–162. [PubMed] [Google Scholar]
  12. 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. doi: 10.1046/j.1365-2648.1999.01086.x. [DOI] [PubMed] [Google Scholar]
  13. 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. doi: 10.1111/j.1365-2648.1991.tb01691.x. [DOI] [PubMed] [Google Scholar]
  14. Mumma C. M. Perceived losses following stroke. Rehabil Nurs. 1986 May-Jun;11(3):19–24. doi: 10.1002/j.2048-7940.1986.tb00502.x. [DOI] [PubMed] [Google Scholar]
  15. Perry S. I., Hsu R. T., 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. doi: 10.1080/13557859998236. [DOI] [PubMed] [Google Scholar]
  16. 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. doi: 10.1177/104973239800800305. [DOI] [PubMed] [Google Scholar]
  17. Pound P., Gompertz P., Ebrahim S. A patient-centred study of the consequences of stroke. Clin Rehabil. 1998 Aug;12(4):338–347. doi: 10.1191/026921598677661555. [DOI] [PubMed] [Google Scholar]
  18. Sabari J. S., Meisler J., Silver E. Reflections upon rehabilitation by members of a community based stroke club. Disabil Rehabil. 2000 May 10;22(7):330–336. doi: 10.1080/096382800296692. [DOI] [PubMed] [Google Scholar]
  19. 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. doi: 10.1046/j.1365-2648.1998.00709.x. [DOI] [PubMed] [Google Scholar]
  20. Young J. B. The primary care stroke gap. Br J Gen Pract. 2001 Oct;51(471):787–788. [PMC free article] [PubMed] [Google Scholar]

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