Six-month reviews for stroke survivors: a study of the modified Greater Manchester Stroke Assessment Tool with care home residents.

Autor:	Patchwood E; Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK., Woodward-Nutt K; Research & Innovation, Northern Care Alliance NHS Group, Salford, UK., Rothwell K; Stroke Support, Stroke Association, London, UK., Perry C; Applied Research Collaboration for Greater Manchester and Division of Population Health, Health Services Research and Primary Care, The University of Manchester, Manchester, UK., Tyrrell P; Stroke Medicine, University of Manchester, UK (Honorary Professor)., Bowen A; Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK.
Jazyk:	angličtina
Zdroj:	Clinical rehabilitation [Clin Rehabil] 2020 May; Vol. 34 (5), pp. 677-687. Date of Electronic Publication: 2020 Mar 23.
DOI:	10.1177/0269215520912515
Abstrakt:	Objectives: To explore the feasibility of using a stroke-specific toolkit for six-month post-stroke reviews in care homes to identify unmet needs and actions. Design: An observational study including qualitative interviews to explore the process and outcome of reviews. Setting: UK care homes. Participants: Stroke survivors, family members, care home staff (review participants) and external staff involved in conducting reviews (assessors). Interventions: Modified Greater Manchester Stroke Assessment Tool (GM-SAT). Results: The observational study provided data on 74 stroke survivors across 51 care homes. In total, out of 74, 45 (61%) had unmet needs identified. Common unmet needs related to blood pressure, mobility, medicine management and mood. We conducted 25 qualitative interviews, including 13 review participants and 12 assessors. Three overarching qualitative themes covered acceptability of conducting reviews in care homes, process and outcomes of reviews, and acceptability of modified GM-SAT review toolkit. The modified GM-SAT review was positively valued, but stroke survivors had poor recall of the review event including the actions agreed. Care home staff sometimes assisted with reviews and highlighted their need for training to support day-to-day needs of stroke survivors. Assessors highlighted a need for clearer guidance on the use of the toolkit and suggested further modifications to enhance it. They also identified organizational barriers and facilitators to implementing reviews and communicating planned actions to GPs and other agencies. Conclusion: The modified GM-SAT provides a feasible means of conducting six-month reviews for stroke survivors in care homes and helps identify important needs. Further modifications have enhanced acceptability. Full implementation into practice requires staff training and organizational changes.
Databáze:	MEDLINE
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