Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study
Abstract Background Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care fo...
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BMC
2025-01-01
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| Series: | Neurological Research and Practice |
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| Online Access: | https://doi.org/10.1186/s42466-024-00360-1 |
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| author | Theresa Schrage Claudia Glissmann Götz Thomalla David Leander Rimmele Holger Schmidt Michael Rosenkranz Stefan Boskamp Martin Härter Levente Kriston |
| author_facet | Theresa Schrage Claudia Glissmann Götz Thomalla David Leander Rimmele Holger Schmidt Michael Rosenkranz Stefan Boskamp Martin Härter Levente Kriston |
| author_sort | Theresa Schrage |
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| description | Abstract Background Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention). Methods As part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees. The multicomponent intervention was implemented in eight participating acute care and rehabilitation clinics. The interviews were analyzed using qualitative content analysis. Contents were coded using eight a priori defined categories (acceptability, adoption, appropriateness, feasibility, fidelity, sustainability, patient-centeredness, satisfaction with treatment, and pandemic-related effects) with the possibility of inductively developed categories. Results Interviews with 21 patients and 34 interviews with 23 employees were conducted. In addition to the deductive categories, three inductive categories (psychosocial implications, interconnectedness, and potential for improvement) emerged. Acceptability, adoption, and appropriateness were assessed positively before the intervention. However, poor feasibility had a negative impact on adoption and appropriateness. In contrast, outcomes related to patient care (patient-centeredness and psychosocial implications) were independent from this effect. Conclusions Similar to other implementation studies of stroke care interventions, implementation of eHealth Services in the StroCare project met barriers in usability and adaptability of new software. However, high adoption and appropriateness in regard to patient-centeredness, psychosocial implications, and an overall benefit for the patients supported continuation of the remaining intervention components. Trial registration The trial is registered at ClinicalTrials.gov (NCT04159324), registration date 12/11/19. |
| format | Article |
| id | doaj-art-9d64638a5bc44627827dd482a629809e |
| institution | Kabale University |
| issn | 2524-3489 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Neurological Research and Practice |
| spelling | doaj-art-9d64638a5bc44627827dd482a629809e2025-01-26T12:58:59ZengBMCNeurological Research and Practice2524-34892025-01-017111010.1186/s42466-024-00360-1Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative studyTheresa Schrage0Claudia Glissmann1Götz Thomalla2David Leander Rimmele3Holger Schmidt4Michael Rosenkranz5Stefan Boskamp6Martin Härter7Levente Kriston8Department of Medical Psychology, University Medical Center Hamburg EppendorfDepartment of Medical Psychology, University Medical Center Hamburg EppendorfDepartment of Neurology, University Medical Center Hamburg EppendorfDepartment of Neurology, University Medical Center Hamburg EppendorfDepartment of Neurology, Elbe Klinikum StadeDepartment of Neurology and Neurological Early Rehabilitation, Albertinen KrankenhausDepartment of Neurology and Neurological Early Rehabilitation, Albertinen KrankenhausDepartment of Medical Psychology, University Medical Center Hamburg EppendorfDepartment of Medical Psychology, University Medical Center Hamburg EppendorfAbstract Background Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention). Methods As part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees. The multicomponent intervention was implemented in eight participating acute care and rehabilitation clinics. The interviews were analyzed using qualitative content analysis. Contents were coded using eight a priori defined categories (acceptability, adoption, appropriateness, feasibility, fidelity, sustainability, patient-centeredness, satisfaction with treatment, and pandemic-related effects) with the possibility of inductively developed categories. Results Interviews with 21 patients and 34 interviews with 23 employees were conducted. In addition to the deductive categories, three inductive categories (psychosocial implications, interconnectedness, and potential for improvement) emerged. Acceptability, adoption, and appropriateness were assessed positively before the intervention. However, poor feasibility had a negative impact on adoption and appropriateness. In contrast, outcomes related to patient care (patient-centeredness and psychosocial implications) were independent from this effect. Conclusions Similar to other implementation studies of stroke care interventions, implementation of eHealth Services in the StroCare project met barriers in usability and adaptability of new software. However, high adoption and appropriateness in regard to patient-centeredness, psychosocial implications, and an overall benefit for the patients supported continuation of the remaining intervention components. Trial registration The trial is registered at ClinicalTrials.gov (NCT04159324), registration date 12/11/19.https://doi.org/10.1186/s42466-024-00360-1StrokeFollow-up careRehabilitationImplementation analysisQualitative content analysisProcess evaluation |
| spellingShingle | Theresa Schrage Claudia Glissmann Götz Thomalla David Leander Rimmele Holger Schmidt Michael Rosenkranz Stefan Boskamp Martin Härter Levente Kriston Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study Neurological Research and Practice Stroke Follow-up care Rehabilitation Implementation analysis Qualitative content analysis Process evaluation |
| title | Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study |
| title_full | Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study |
| title_fullStr | Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study |
| title_full_unstemmed | Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study |
| title_short | Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study |
| title_sort | process evaluation of a cross sectoral coordinated follow up care of stroke patients a qualitative study |
| topic | Stroke Follow-up care Rehabilitation Implementation analysis Qualitative content analysis Process evaluation |
| url | https://doi.org/10.1186/s42466-024-00360-1 |
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