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Factors influencing the implementation of Home-Based Stroke Rehabilitation: Professionals' perspective.
van der Veen, Dinja J; Döpp, Carola M E; Siemonsma, Petra C; Nijhuis-van der Sanden, Maria W G; de Swart, Bert J M; Steultjens, Esther M.
Afiliación
  • van der Veen DJ; Institute of Health Studies, University of Applied Sciences HAN, Nijmegen, the Netherlands.
  • Döpp CME; Healthy Living, TNO Leiden, Leiden, the Netherlands.
  • Siemonsma PC; Healthy Living, TNO Leiden, Leiden, the Netherlands.
  • Nijhuis-van der Sanden MWG; University of Applied Sciences THIM, Nieuwegein, the Netherlands.
  • de Swart BJM; Faculty of Health, University of Applied Sciences Leiden, Leiden, the Netherlands.
  • Steultjens EM; Research Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, the Netherlands.
PLoS One ; 14(7): e0220226, 2019.
Article en En | MEDLINE | ID: mdl-31344103
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.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Percepción / Actitud del Personal de Salud / Cuidadores / Rehabilitación de Accidente Cerebrovascular / Servicios de Atención de Salud a Domicilio Tipo de estudio: Prognostic_studies / Qualitative_research / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Percepción / Actitud del Personal de Salud / Cuidadores / Rehabilitación de Accidente Cerebrovascular / Servicios de Atención de Salud a Domicilio Tipo de estudio: Prognostic_studies / Qualitative_research / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos