Patient-centred stroke care: developing a toolkit for clinicians

Introduction:
With increasing emphasis being placed on involving patients in the determination of their care, health professionals worldwide have recognised a need for clinical outcomes measures that will facilitate the delivery of patient-centred care in a range of care settings.

Method:
We undertook a mixed methods review of the literature to identify stroke-specific patient-centred outcomes measures. Descriptive statistics were used to report the quantitative data. In addition,as an analytical method was required that was sufficiently flexible to permit the integration of both quantitative and qualitative papers,the review papers were also subject to thematic analysis.Results: The review enabled the identification of three patient-centred outcomes measures i.e. comprehensive measures, sensitive to change over time that had been developed to incorporate patients’perspectives of needs and priorities following stroke: the Subjective Index of Physical and Social Outcomes, Stroke Impact Scale, and the Communication Outcome after Stroke scale. As a result of the thematic analysis, three broad themes were described: meaningfulness and relevance and quality and communication, which informed the development of a definition of patient-centred care specific to the speciality of stroke.

Conclusion:
The systematic review informed the development of an evidence-based definition of patient-centred stroke care against which stroke healthcare professionals can benchmark their practice. The review also identified three outcomes measures that will help stroke healthcare professionals to monitor and measure their practice and to measure patient-centred outcomes, thus ensuring the meaningfulness, relevance and effectiveness of their practice, from the perspective of patients and their families.