From: A conceptual model of treatment burden and patient capacity in stroke
Type of treatment burden | Healthcare workload | Care deficiencies |
---|---|---|
Making sense of stroke management and planning care | • Understanding symptoms, investigations, treatments, risk factors • Information gathering • Taking responsibility • Goal setting & prioritising • Problem solving • Managing uncertainty & maintaining motivation • Developing coping strategies • Coping with negative emotions | • Lack of information provision & poor signposting • Information hard to understand • Poorly timed information • Not enough verbal information • Not tailored to individual • Lack of support with care planning |
Interacting with others | • Seeking advice or help from health and social care professionals • Gaining support from friends, family, fellow patients • Strained relationships • Protecting carers • Stigma | • Misdiagnosis • Paternalism • Lack of understanding • Mismatch in ideas • Poor access to GP • Poorly co-ordinated care • Poor continuity • Poor communication from GP |
Enacting management strategies | • Acute care • Inpatient rehabilitation • Discharge home or to care home • Community rehabilitation • Outpatient appointments • Medications • Risk factor modification • Co-morbidities • Adaptations to home • Home care • Return to driving and employment • Mobility aids • Finances • Enacting coping strategies • Psychological adjustment • Alternative therapies | • Waiting times as inpatient • Unpleasant ward • Poorly supported discharge • Poor GP follow up • Poor follow up for milder cases • Lack of help with transport to appointments • Complicated medication regimes • Poor access to home adaptations and walking aids • Substandard home care • Poor access to driving assessment • Complicated benefits system • Lack of psychological support and support groups |
Reflecting on management | • Routine appointments for review • Joint healthcare decisions • Reflecting on progress • Non-adherence • Keeping up to date • Worry about another stroke | • Lack of review for milder cases • Poor long term follow up for all |