What helps and hinders the provision of healthcare that minimises treatment burden and maximises patient capacity? A qualitative study of stroke health professional perspectives

Kyle, J., Skleparis, D. , Mair, F. S. and Gallacher, K. I. (2020) What helps and hinders the provision of healthcare that minimises treatment burden and maximises patient capacity? A qualitative study of stroke health professional perspectives. BMJ Open, 10(3), e034113. (doi: 10.1136/bmjopen-2019-034113) (PMID:32193265)

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Abstract

OBJECTIVES: Treatment burden is the healthcare workload experienced by individuals with long-term conditions and the impact on well-being. Excessive treatment burden can negatively affect quality-of-life and adherence to treatments. Patient capacity is the ability of an individual to manage their life and health problems and is dependent on a variety of physical, psychological and social factors. Previous work has suggested that stroke survivors experience considerable treatment burden and limitations on their capacity to manage their health. We aimed to examine the potential barriers and enablers to minimising treatment burden and maximising patient capacity faced by health professionals and managers providing care to those affected by stroke. SETTING: Primary and secondary care stroke services in a single health board area in Scotland. PARTICIPANTS: Face-to-face qualitative interviews with 21 participants including stroke consultants, nurses, physiotherapists, occupational therapists, speech and language therapists, psychologists, general practitioners and health-service managers. OUTCOME MEASURES: Data were analysed using thematic analysis to ascertain any factors that influence the provision of low-burden healthcare. RESULTS: Barriers and facilitators to the provision of healthcare that minimises treatment burden and maximises patient capacity were reported under five themes: healthcare system structure (e.g. care coordination and autonomous working); resources (e.g. availability of ward nurses and community psychologists); knowledge and awareness (e.g. adequate time and materials for optimal information delivery); availability of social care (e.g. waiting times for home adaptations or extra social support) and patient complexity (e.g. multimorbidity). CONCLUSIONS: Our findings have important implications for the design and implementation of stroke care pathways, emphasising the importance of removing barriers to health professional provision of person-centred care. This work can inform the design of interventions aimed at nurturing autonomous working by health professionals, improving communication and care coordination or ensuring availability of a named person throughout the patient journey.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Kyle, Dr John and Gallacher, Dr Katie and Mair, Professor Frances and Skleparis, Dr Dimitris
Authors: Kyle, J., Skleparis, D., Mair, F. S., and Gallacher, K. I.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Social Sciences > School of Social and Political Sciences > Politics
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:18 March 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in BMJ Open 10(3):e034113
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
301100Optimising healthcare for stroke survivors - a study of health professional perspectives on minimising treatment burden and maximising patient capacityKatie GallacherNHS Greater Glasgow and Clyde Endowment Funds (NHSGGCEN)GN17ST385 Cost Centre G47HW - General Practice and Primary Care