Needs of Patients, Family Caregivers, and Nurses in Community-Based Stroke Care

Abstract

Introduction Stroke is a leading cause of mortality among non-communicable diseases. However, research on the need for community-based stroke care remains limited, particularly among key stakeholders such as stroke patients, family caregivers, and nurses working in primary care units (PCUs). 

Objective This descriptive qualitative study aimed to describe the care needs of stroke patients, family caregivers and nurses working in primary care units.

Design This study was descriptive qualitative research.

Methodology The study participants included 35 nurses working in primary care units across four provinces in central Thailand, and 25 stroke patients or their family caregivers, selected through purposive sampling. Data were collected using in-depth interviews and focus group discussions guided by semi-structured interview questions. The data were analyzed using content analysis.

Results The majority of stroke patients had been diagnosed with hypertension (80%), and only five patients were in the recovery stage. The average duration of service utilization at the primary care unit was 60 months. The needs of patients and family caregivers included: 1) information regarding warning signs and treatment, 2) social support and care networks, 3) emergency health care services and 4) efficient service delivery and positive communication. Patients and caregivers expressed structural needs related to staffing and infrastructure, including a desire for increased nursing personnel and more spacious service areas with sufficient seating. Process-related needs included educational information on stroke prevention and warning signs, such as dietary guidelines, physical activity, smoking cessation, and symptom monitoring. Additionally, there was a need for emergency care and efficient services and communication for patients requiring long-term care. All nurses were female, with a median of 8 years of experience working in primary care settings. Their expressed needs included: 1) emergency care skills, 2) professional competencies in management and administration, and 3) efficiency of care delivery system.

Recommendation The findings of this study suggest the need for developing a comprehensive care management guideline for stroke patients. Key recommendations include enhancing emergency care competencies among nurses working in primary care settings, improving the efficiency of management systems, strengthening care networks and support mechanisms, and ensuring the provision of medical tools and equipment that align with the needs of patients and caregivers. These measures aim to improve health outcomes and the quality of stroke care within community settings.