Development of Monitoring and Evaluating Problems of Stroke Patients for Referral Form for Post Stroke Patients in Community
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Abstract
Stroke patients need to be evaluated and monitored for their problems for a long-term care. This research aimed to develop a form for monitoring and evaluating problems of post-stroke patients in the community if needed. The methodology employed a research and development design, which consisted of a survey of problems, developing and testing the tool, and tool evaluation. This study was conducted among three groups of participants: (1) 15 post-stroke patient caregivers, (2) 20 experts evaluating the continuing care for post-stroke patients in the community, (3) a group of 60 persons trying the tool, and (4) 336 people for the tool evaluation. The research tools included (1) a form evaluating the consistency of continuing care for post-stroke patients in the community, (2) a questionnaire assessing general data, and (3) a form assessing and evaluating problems of post-stroke patients in the community. Data were collected using questionnaires and analyzed using descriptive statistics. The Cohen's Kappa statistic was used to evaluate inter-rater reliability (IRR). The monitoring and evaluating problems of stroke patients in the community form for referral was developed as a checklist composed of 13 items, including: 1) Receiving a visit from a public health official after being discharged from the hospital; 2) Weakness after being discharged from the hospital; 3) Problems of communication with others after a stroke; 4) Daily activities; 5) Poor balance in a sitting position; 6) Spasticity; 7) Pain; 8) Chance of an accident by falling; 9) Fecal and urinary incontinence after suffering a stroke; 10) Emotional problems; 11) Intellectual disability; 12) Problems of relationships with family; and 13) Living after a stroke. This tool showed the highest consistency between raters, with 98.81 percent and a Kappa statistic value of 1. Therefore, this tool is suitable to use for monitoring and evaluating the post-stroke patients in the community at least once a week in order to properly and timely manage them, resulting in more efficient post-stroke care in the community.
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บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
References
Office of nursing. Criteria for quality of home visiting work. Office of the Permanent Secretary, Ministry of Public Health. Nonthaburi: Agricultural Cooperatives Association of Thailand printing house. 2014.(in Thai)
Sang-Ngam T. A model of stroke competency development for nurses at sub-district health promoting hospitals. Doctor of Philosophy thesis, Leadership field for professional development [dissertation]. Buriram: Buriram Rajabhat University; 2017.(in Thai)
Abdul Aziz AF, Mohd Nordin NZ, Fairuz Ali M, Abd Aziz NA, Sulong S, Mohamed Aljunid S. The integrated care pathway for post-stroke patients (iCaPPS): a shared care approach between stakeholders in areas with limited access to specialist stroke care services. BMC Health Services Research. 2017;17(35):1-11.
Akgul E, Cifcili S, Kaya CA. Developing a post-stroke home care checklist for primary care professionals in Turkey: a modified Delphi study. Primary Health Care Research & Development. 2023;24(e22):1–6.
Kjork EK, Carlsson G, Sunnerhagen KS, Lundgren-Nilsson A. Experiences using the post-stroke checklist in Sweden with a focus on feasibility and relevance: a mixed method design. BMJ Open. 2019; 9(e028218):1-8.
Turner RC, Carlson L. Indexes of item-objective congruence for multidimensional items. International journal of testing. 2003;3(2):163-170.
McHugh ML. Interrater reliability: the kappa statistic. Biochemia Medica. 2012;22(3):276-282.
Pak Chun Chau J, Hoi Shan Lo S, Butt L, Liang S. Post-stroke experiences and rehabilitation needs of Community-Dwelling Chinese stroke survivors: A qualitative study. International Journal of Environmental Research and Public Health. 2022;19(16345):1-13.
Izham M, Juraime F, Mansor AN. Malaysian principals’ technology leadership practices and curriculum management. Creative Education. 2016;7(1):922-30.
Piriyaprasarth P. Factors assessment tool for stroke patients. Thai journal of Physical Therapy. 2016;38(3):128-39.(in Thai)
Phanram M, Singsalasang A, Nguanjairak R. Factors associated with duration time rehabilitation of stroke patient in the community at Buriram province. Journal of The Royal Thai Army Nurses. 2022;23(3):296-304.(in Thai)
Turner GM, Mullis R, Lim L, Kreit L, Mant J. Using a checklist to facilitate management of long-term care needs after stroke: insights from focus groups and a feasibility study. BMC Family Practice. 2019;20(2):1-8.
Ward AB, Chen C, Norrving B, Gillard P, Walker MF, Blackburn S, et al. Evaluation of the post stroke checklist: a pilot study in the United Kingdom and Singapore. Int J Stroke. 2014;9(3):76–84.
Pasunont P. Evaluation of inter-rater reliability using Kappa statistics. The journal of Faculty of Applied Arts. 2015;January - June:2-20.(in Thai)
Pingmuang P, Chinchai P, Dhippayom JP. Internal Consistency and Inter-rater reliability of the functional test for hemiplegic upper extremity in persons with hemiplegia – Thai version. J Thai Rehabil Med. 2016;26(2):39-46.(in Thai)
Mongkolsuebsakul W. Access to public health services in Thailand: reflection and inequality of socially vulnerable groups. Journal of Humanities and Social Sciences, Southeast Asia University. 2022;6(1):55-69.(in Thai)