Postacute-Stroke Management Problems in Home Care Service: A Qualitative Single-Centered Study in Yogyakarta, Indonesia.

Abstract

Objective This study explores the postacute-stroke management problems, particularly for patients with total dependency (Barthel Index <20), in home care service of Dr. Sardjito Hospital (SH) from the hospital personnel's and caregiver's points of view. Materials and Methods In-depth interviews with a semi-structured interview guide were conducted with hospital personnel and patients' caregivers based on the purposeful sampling. There were 10 hospital personnel that were interviewed: the director of medical service, head of home care unit, neurologists, general practitioners, nurses, and physiotherapist. There were eight caregivers who participated in the study. Statistical Analysis Data from the interviews were analyzed using systematic text condensation using Nvivo 12 plus. Results Our findings showed that all health personnel in SH agreed that home care service is a part of an integrated health care service for continuation of care. However, the preparedness by the hospital management is still lacking in infrastructures, such as standardized operational procedure, quality control, and financial system, as well as in terms of competent human resources and their welfare. In addition, the patient's family and caregiver are lacking in knowledge and independency to take care of the patients with the need of home care services' monitoring to deliver the expected home care for postacute-stroke's patient regularly. Conclusion Home care service is an act of implementing hospital obligation to fulfill the patients' rights. An established hospital policy to ensure a comprehensive home care service delivery is necessary. The capability and welfare of the health care personnel should be put into account for the standardized human resources.