Factors Influencing the Implementation of Home-Based Stroke Rehabilitation: Professionals' Perspective

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Jul 26

PMID 31344103

Citations 10

Authors

Dinja J van der Veen

Carola M E Dopp

Petra C Siemonsma

Maria W G Nijhuis-van Der Sanden

Bert J M de Swart

Esther M Steultjens

Affiliations

Soon will be listed here.

Abstract

Background: Stroke has a major impact on survivors and their social environment. Care delivery is advocated to become more client-centered and home-based because of their positive impact on client outcomes. The objective of this study was to explore professionals' perspectives on the provision of Home-Based Stroke Rehabilitation (HBSR) in the Netherlands and on the barriers and facilitators influencing the implementation of HBSR in daily practice.

Methods: Semi-structured focus groups were conducted to explore the perspectives of health and social care professionals involved in stroke rehabilitation. Directed content analysis was performed to analyze the transcripts of recorded conversations.

Results: Fourteen professionals participated in focus groups (n = 12) or, if unable to attend, an interview (n = 2). Participants varied in professional backgrounds and roles in treating Dutch clients post stroke. Barriers and facilitators influencing the implementation of HBSR in daily practice were identified in relation to: the innovation, the user, the organization and the socio-political context. Participants reported that HBSR can be efficient and effective to most clients because it facilitates client- and caregiver-centered rehabilitation within the clients' own environment. However, barriers in implementing HBSR were perceived in a lack of (structured) inter-professional collaboration and the transparency of expertise of primary care professionals. Also, the current financial structures for HBSR in the Netherlands are viewed as inappropriate.

Discussion: In line with previous studies, we found that HBSR is recognized by professionals as a promising alternative to institution-based rehabilitation for clients with sufficient capabilities (e.g. their own health and informal support).

Conclusion: Multiple factors influencing the implementation of HBSR were identified. Our study suggests that, in order to implement HBSR in daily practice, region specific implementation strategies need to be developed. We recommend developing strategies concerning: organized and coordinated inter-professional collaboration, transparency of the expertise of primary care professionals, and the financial structures of HBSR.

Citing Articles

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Factors influencing the implementation of early discharge hospital at home and admission avoidance hospital at home: a qualitative evidence synthesis.

Wallis J, Shepperd S, Makela P, Han J, Tripp E, Gearon E Cochrane Database Syst Rev. 2024; 3:CD014765.

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Acceptability of Telerehabilitation: Experiences and Perceptions by Individuals with Stroke and Caregivers in an Early Supported Discharge Program.

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The importance of context-a qualitative study exploring healthcare practitioners' experiences of working with patients at home after a stroke.

Elf M, Rasoal D, Zingmark M, Kylen M BMC Health Serv Res. 2023; 23(1):733.

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A qualitative evidence synthesis exploring people after stroke, family members, carers and healthcare professionals' experiences of early supported discharge (ESD) after stroke.

O Connor E, Dolan E, Horgan F, Galvin R, Robinson K PLoS One. 2023; 18(2):e0281583.

PMID: 36780444 PMC: 9925006. DOI: 10.1371/journal.pone.0281583.

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