Supportive Care Needs Following an Acute Stroke: A Descriptive Enquiry of Caregivers' Perspective

Abstract

Thesis Objectives The thesis research was undertaken to improve knowledge about caregivers needs and develop a means of assessment for the acute care sector. Specific objectives were: 1) identify and evaluate the applicability of a supportive care framework to guide in the comprehensive assessment of the needs of informal caregivers of patients with stroke, 2) describe the needs reported by a cohort of active caregivers, and 3) assess the utility of a tool for application in acute care stroke practice. Population and Setting Family caregivers of patients admitted to hospital with an acute stroke in a major urban center. Focus group of nurses employed in acute stroke care at a regional stroke centre. Methods 1) Integrative study of the stroke research was conducted to identify the type and range of reported needs. 2) Mixed methods exploratory study of family caregivers of patients with acute stroke was conducted. 3) Focus group of nurses employed in acute stroke care was carried out to evaluate the applicability and feasibility of the assessment tool. Results Integrative Study: Seventeen studies that reported on the needs of family caregivers of patients with acute stroke were identified. Reported needs were wide ranging, crossed all domains and are similar to those reported in the stroke population. Exploratory Study: Ten family caregivers participated in a needs assessment using an already developed survey modified for the stroke population. All fully completed the 42 item survey and six of these caregivers initiated an impromptu post-survey discussion. The cohort of caregivers reported unmet needs in the six domains. Nurses employed in acute stroke care reported that the new caregiver assessment would be useful in identifying family caregiver needs. Conclusions The study identified a wide spectrum of needs experienced by this cohort of caregivers. Both caregivers and nurses found the assessment approach valuable in improving this area of care. Further refinement and validation of the survey would provide the specificity to identify the very different needs of individual families and would provide direction to the healthcare community in planning for a more seamless transition across the continuum.