How integrated care can alleviate treatment burden in stroke survivors

Abstract

In Ireland, approximately 10,000 people will have a stroke event each year and there is currently 30,000 people living in Ireland with disabilities as a result of stroke (McElwaine, McCormack & Harbison, 2016). Advances in modern healthcare have led to improved patient outcomes following stroke, however, the challenges to the healthcare system in recent years has placed an increased burden on patients to self-manage their individual healthcare needs. Excessive treatment burden can negatively affect outcomes. The aim of this thesis was to explore whether treatment burden exists in stroke survivors and to examine to what extent this burden impacts on self-care. Using a qualitative research approach called Interpretative Phenomenological Analysis (IPA), this study explored the experiences of six stroke survivors as they engaged in neuro-rehabilitation and set about managing their self-care. In depth interviews with six stroke survivors were carried out and analysed using the principles of IPA. Analysis of the data revealed a series of superordinate and overarching themes for each participant and a set of common themes which reflect stroke survivors’ experiences. Themes included ‘sense making’, ‘profound loss’ and ‘acceptance’. Overall there was no evidence of treatment burden in this study and participants were self-managing their healthcare needs with personal and professional support. This thesis provides important insights into the concept of treatment burden as experienced by stroke survivors in Ireland, the factors that affect their experience of, and capacity to, manage their care. Findings have important implications for the improvement and redesign of healthcare delivery.