Advertisement

Consensus development of components of continuity of care for stroke patients: a Delphi methodology

  • Lin Xiao
  • Yulin Gao
  • Lili Zhang
Original Article
  • 5 Downloads

Abstract

Aims

The study aimed to develop consensus on the components of continuity of care for stroke patients in the cultural context of China.

Subjects and methods

Thirteen experts were recruited purposefully to finish this study. A Delphi approach was adopted to reach consensus on the components of continuity of care, and 75% agreement was used as cutoff.

Results

Three rounds of consultation were completed. Consensus (75% agreement) was obtained on 45 of the 49 statements. The final agreed list of statements represented three domains: the structure, process and outcome of continuity of care.

Conclusions

It represents the first attempt to develop consensus on the components of continuity of care for Chinese patients with stroke. According to the established framework and components of continuity of care, health professionals can successfully implement continuity of care for stroke patients and improve the quality of care.

Keywords

Continuity of care Stroke Rehabilitation Delphi method 

Notes

Acknowledgements

We thank all the experts that consented to take part in our study. This study was funded by the Southern Medical University, grant Q2016002.

Funding

This study was funded by the Southern Medical University, grant Q2016002.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

References

  1. Berthier ML (2005) Post-stroke aphasia: epidemiology, pathophysiology and treatment. Drugs Aging 22:163–182CrossRefPubMedGoogle Scholar
  2. Bray Hall ST (2012) Transitional care: focusing on patient-centered outcomes and simplicity. Ann Intern Med 157(6):448–449CrossRefPubMedGoogle Scholar
  3. Donabedian A (2003) An introduction to quality assurance in health care, vol 1, 1st edn. Oxford University Press, New YorkGoogle Scholar
  4. Eskes AM, Maaskant JM, Holloway S, Van DN, Alves P, Legemate DA, Ubbink DT, Vermeulen H (2015) Competencies of specialised wound care nurses: a European delphi study. Int Wound J 11(6):665–674CrossRefGoogle Scholar
  5. Fisher RJ, Gaynor C, Kerr M, Langhorne P, Anderson C, Bautz-Holter E, Indredavik B, Mayo NE, Power M, Rodger H, Ronning OM, Widen Holmqvist L, Wolfe CD, Walker MF (2011) A consensus on stroke: early supported discharge. Stroke 42(5):1392–1397CrossRefPubMedGoogle Scholar
  6. Frances RN, Siu RN (2015) Effects of a 4-week transitional care programme for discharged stroke survivors in Hong Kong: a randomised controlled trial. Health & Social Care in the Community 23(6):619CrossRefGoogle Scholar
  7. Haggerty JL, Reid RJ, Freeman GK, Barbara HS, Carol EA, Rachael M (2003) Continuity of care: a multidisciplinary review. BMJ 327(7425):1219–1221CrossRefPubMedPubMedCentralGoogle Scholar
  8. Johnston SC, Mendis S, Mathers CD (2009) Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modeling. Lancet Neurol 8:345–354CrossRefPubMedGoogle Scholar
  9. Jones J, Hunter D (1995) Consensus methods for medical and health services research. BMJ 311:376–380CrossRefPubMedPubMedCentralGoogle Scholar
  10. Keeney S, Hasson F, McKenna H (2006) Consulting the oracle: ten lessons from using the Delphi technique in nursing research. J Adv Nurs 53(2):205–212CrossRefPubMedGoogle Scholar
  11. Liu L, Wang D, Wong KS, Wang Y (2011) Stroke and stroke care in China: huge burden, significant workload, and a national priority. Stroke 42(12):3651–3654CrossRefPubMedGoogle Scholar
  12. Lynch EB, Butt Z, Heinemann A, Victorson D, Cindy JN, Lori P, Cella D (2008) A qualitative study of quality of life after stroke: the importance of social relationships. Journal of Rehabilitation Medicine Official Journal of the Uems European Board of Physical & Rehabilitation Medicine 40(7):518–523CrossRefGoogle Scholar
  13. McKenna HP (1994) The Delphi technique: a worthwhile research approach for nursing? J Adv Nurs 19:1221–1225CrossRefPubMedGoogle Scholar
  14. Moore L, Lavoie A, Bourgeois G, Lapointe J (2015) Donabedian’s structure-process-outcome quality of care model: Validation in an integrated trauma system. J Trauma Acute Care Surg 78(6):1168CrossRefPubMedGoogle Scholar
  15. Murphy MK, Black NA, Lamping DL, McKee CM, Sanderson CF, Askham J, Marteau T (1998) Consensus development methods, and their use in clinical guideline development. Health Technol Assess 2(3):1–88Google Scholar
  16. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2197–2223CrossRefPubMedGoogle Scholar
  17. Olson DM, Bettger JP, Alexander KP, Kendrick AS, Irvine JR, Wing L, Coeytaux RR, Dolor RJ, Duncan PW, Graffagnino C (2011) Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention. Evidence Report/technology Assessment 202(202):1Google Scholar
  18. Phillips CO, Wright SM, Kern DE, Singa RM, Shepperd S, Rubin HR (2004) Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA 291:1358–1367CrossRefPubMedGoogle Scholar
  19. Philp I, Brainin M, Walker MF, Ward AB, Gillard P, Shields AL, Norrving B (2013) Development of a poststroke checklist to standardize follow-up care for stroke survivors. Journal of Stroke & Cerebrovascular Diseases the Official Journal of National Stroke Association 22(7):173–180CrossRefGoogle Scholar
  20. Reid R (2002) Defusing the Confusion: Concepts and Measures of Continuity of Healthcare. Canadian Health Services Research Foundation, OttawaGoogle Scholar
  21. Saywell N, Vandal AC, Brown P, Hanger HC, Hale L, Mudge S, Milosavljevic S, Feigin V, Taylor D (2012) Telerehabilitation to improve outcomes for people with stroke: study protocol for a randomised controlled trial. Trials 13(1):233–233CrossRefPubMedPubMedCentralGoogle Scholar
  22. Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, Bauermann T, Weibrich C, Vucurevic GD, Schneider A, Wissel J (2010) Occurence and clinical predictors of spasticity after ischemic stroke. Stroke 41(9):2016–2020CrossRefPubMedGoogle Scholar
  23. Vella K, Goldfrad C, Rowan K, Bion J, Black N (2000) Use of consensus development to establish national research priorities in critical care. BMJ 13(4):163Google Scholar
  24. Wang D, Wu L, Zhang XF (2016) Application effects of structure-process-outcome three dimensional quality assessment model on transitional care in patients with COPD. Chin J Mod Nurs 22(2):156–159Google Scholar
  25. Wang Y, Yang F, Shi H, Yang C, Hu H (2017) What type of transitional care effectively reduced mortality and improved adl of stroke patients? A meta-analysis. Int J Environ Res Public Health 14(5):510CrossRefPubMedCentralGoogle Scholar
  26. Wissel J, Olver J, Sunnerhagen KS (2013) Navigating the post-stroke continuum of care. J Stroke Cerebrovasc Dis 22:1–8CrossRefPubMedGoogle Scholar
  27. Wong EL, Yam CH, Cheung AW, Leung MC, Chan FW, Wong FY (2011) Barriers to effective discharge planning: a qualitative study investigating the perspectives of frontline healthcare professionals. BMC Health Serv Res 11(1):242–242CrossRefPubMedPubMedCentralGoogle Scholar
  28. Yam Carrie HK, Wong Eliza LY, Cheung Annie WL, Chan FW, Wong Fiona YY, Eng-Kiong Y (2012) Framework and components for effective discharge planning system: a delphi methodology. BMC Health Serv Res 12(1):396CrossRefPubMedPubMedCentralGoogle Scholar
  29. Ytterberg C, Thorsén AM, Liljedahl M, Holmqvist LW, von Koch L (2010) Changes in perceived health between one and five years after stroke: a randomized controlled trial of early supported discharge with continued rehabilitation at home versus conventional rehabilitation. J Neurol Sci 294(1):86–88CrossRefPubMedGoogle Scholar
  30. Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S (2016) Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet 387(10015):251–272CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of NursingSouthern Medical UniversityGuang ZhouChina

Personalised recommendations