Abstract
Background: Person-centred practice promotes patients as partners in their own care and is underpinned by a respect for personhood (Britten et al., 2017; McCormack et al., 2021). The approach is a key component of high-quality healthcare(WHO, 2016) which improves health outcomes and patient, informal carer, and staff satisfaction (Ekman et al., 2012; Rathert et al., 2013). Person-centred practice is recommended to improve outcomes in stroke care (ref). The objective of this study is to explore healthcare professionals’ and patients’ experiences with person-centred practice in the stroke patient trajectory.
Methods: To explore person-centred practice in the stroke patient trajectory(Helsedirektoratet, 2022), we used a mixed-methods approach (Tashakkori A, 2023) that integrates the perspectives of healthcare professionals and patients involved in the stroke care journey. We conducted a survey with healthcare professionals, using the Norwegian version of the Person-Centred Practice Inventory - Staff (PCPI-S) questionnaire (Bing-Jonsson et al., 2018; Slater et al., 2017), followed up with in-depth interviews with a smaller group (n=5) to gain deeper insights into their experiences with person-centred care. Additionally, we conducted semi-structured interviews with stroke patients, focusing on their experiences from hospitalisation and within the first three months post-stroke. The interview guide, based on the person-centred practice framework, explores each stage from admission to early rehabilitation and aims to understand how person-centred practices may vary across settings (prehospital/hospital/post-hospital).
Results: Preliminary results indicate that stroke patients have different experiences of patient-centred practices in the acute phase of their stroke versus in the rehabilitation phase. Patients reported that during the acute phase, care was often task-focused, with limited opportunities for shared decision-making or personal input. In contrast, during the rehabilitation phase, patients generally experienced a more person-centred approach. Healthcare professionals highlighted challenges in implementing person-centred practices during the acute phase due to time constraints and the high-pressure environment.
Implications: This study provides insights into the differences in person-centred practices throughout the stroke patient trajectory, as well as patients' and healthcare professionals' experiences, including their needs and the impact of the care environment. The results of this study will inform strategies to strengthen person-centred practice in the stroke patient trajectory.
Keywords
Person-centred practice, stroke patient trajectory, mixed-methods.