BMJ Open (Oct 2023)

Healthcare professionals’ perspectives of the provision of, and challenges for, eating, drinking and psychological support post stroke: findings from semistructured interviews across India

  • ,
  • Sandy Middleton,
  • Mark Gabbay,
  • Gordon Prescott,
  • Marion Walker,
  • Anil Sharma,
  • Anand Dixit,
  • Jo Gibson,
  • Maree Hackett,
  • Sudhir Sharma,
  • Caroline Sanders,
  • Stephanie P Jones,
  • Andy Clegg,
  • Jeyaraj D Pandian,
  • Dominique Cadilhac,
  • Girish Baburao Kulkarni,
  • Dame Caroline Watkins,
  • Ranjit J Injety,
  • Sanjali Ratra,
  • PN Sylaja,
  • Veena Babu,
  • MV Padma Srivastava,
  • Sakshi Sharma,
  • Jemin Webster,
  • Amrit Koirala,
  • Pawna Kaushal,
  • Arvind Sharma,
  • Jagruti Prajapati,
  • Jo Catherine Weldon,
  • Jennifer A Kuroski,
  • Caroline Leigh Watkins,
  • Catherine Elizabeth Lightbody,
  • MV Padma Srivastava,
  • Liz Boaden,
  • Denise Forshaw,
  • Rachel Georgiou,
  • Steph Jones,
  • Liz Lightbody

DOI
https://doi.org/10.1136/bmjopen-2022-069150
Journal volume & issue
Vol. 13, no. 10

Abstract

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Aim This qualitative study explores with health professionals the provision of, and challenges for, postdischarge stroke care, focussing on eating, drinking and psychological support across India.Design Qualitative semistructured interviews.Setting Seven geographically diverse hospitals taking part in a Global Health Research Programme on Improving Stroke Care in India.Participants A purposive sample of healthcare professionals with current experience of working with patients who had a stroke.Results Interviews with 66 healthcare professionals (23 nurses (14 staff nurses; 7 senior nurse officers; 1 intensive care unit nurse; 1 palliative care nurse)); 16 doctors (10 neurologists; 6 physicians); 10 physiotherapists; 5 speech and language therapists; 4 occupational therapists; 4 dieticians; 2 psychiatrists; and 2 social workers resulted in three main themes: integrated inpatient discharge care planning processes; postdischarge patient and caregiver role and challenges; patient and caregiver engagement post discharge.Conclusions Discharge planning was integrated and customised, although resources were limited in some sites. Task shifting compensated for a lack of specialists but was limited by staff education and training. Caregivers faced challenges in accessing and providing postdischarge care. Postdischarge care was mainly hospital based, supported by teleservices, especially for rural populations. Further research is needed to understand postdischarge care provision and the needs of stroke survivors and their caregivers.