Att få stroke i Örebro län - Uppföljning av vårdkvalitet och upplevelser av stöd, vård och rehabilitering
Background: Various follow-up studies show that there are deficiencies in the care of patients affected by stroke. In order to provide good care according to the National Board of health and welfare and national guidelines for stroke care systematic quality audits need to be carried out.
Purpose: To investigate if the local guidelines for stroke care in Örebro County are followed and to explore how people with stroke experience care and rehabilitation in hospital, primary care and community.
Method: Primary health care records were reviewed using quality indicators in the local stroke guidelines. Samples of patients were obtained from the County´s three hospitals. Differences between men and women, younger and older, were analysed with chi-squared test. Eleven people were interviewed about their experiences of care, rehabilitation, support and participation. The interviews were analysed with qualitative content analysis.
Result: 123 records were reviewed and for 69% referrals had been sent to the primary health care. Of the referred patients 78% were followed up within 6 months. Men were treated in significantly higher extent with lipid-lowering medicines compared with women, and people below 75 years in significantly higher extent than those over 75 years. Diagnosis was significantly more frequent registered in records for younger people. The interviewed people were at large satisfied with the hospital care. Those who lived in municipal residents enjoyed company of the staff and the other people living there but could also feel restricted by the ward routines and partially lose their autonomy. Some experienced the primary health care as a security while others experienced a lack of follow-up despite the fact that it happened. Several felt not involved in the health care planning, but instead relied on staff´s judgement.
Conclusion: Quality indicators were met in large in the primary health care but there were differences between gender and between older and younger. People were generally satisfied with care but they did not feel involved in the health care planning. People living in municipal residents experienced some shortcomings and described loss of autonomy.
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