{"id":460630,"date":"2022-06-10T14:50:02","date_gmt":"2022-06-10T11:50:02","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/improving-stroke-care-what-survivors-say\/"},"modified":"2022-06-10T14:50:02","modified_gmt":"2022-06-10T11:50:02","slug":"improving-stroke-care-what-survivors-say","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/improving-stroke-care-what-survivors-say\/","title":{"rendered":"#Improving stroke care: What survivors say"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a2f085640d39\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #dd3333;color:#dd3333\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #dd3333;color:#dd3333\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a2f085640d39\" checked aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/buradabiliyorum.com\/en\/improving-stroke-care-what-survivors-say\/#%E2%80%9CImproving_stroke_care_What_survivors_say%E2%80%9D\" >&#8220;Improving stroke care: What survivors say&#8221;<\/a><\/li><\/ul><\/nav><\/div>\n<h1><span class=\"ez-toc-section\" id=\"%E2%80%9CImproving_stroke_care_What_survivors_say%E2%80%9D\"><\/span>&#8220;Improving stroke care: What survivors say&#8221;<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<div>\n<div class=\"article-gallery lightGallery\">\n<div data-thumb=\"https:\/\/scx1.b-cdn.net\/csz\/news\/tmb\/2020\/stroke.jpg\" data-src=\"https:\/\/scx2.b-cdn.net\/gfx\/news\/hires\/2020\/stroke.jpg\" data-sub-html=\"Credit: CC0 Public Domain\">\n<figure class=\"article-img\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/scx1.b-cdn.net\/csz\/news\/800a\/2020\/stroke.jpg\" alt=\"stroke\" title=\"Credit: CC0 Public Domain\" width=\"800\" height=\"481\"\/><figcaption class=\"text-darken text-low-up text-truncate-js text-truncate mt-3\">\n                Credit: CC0 Public Domain<br \/>\n            <\/figcaption><\/figure>\n<\/p><\/div>\n<\/div>\n<p>New Zealand stroke survivors have told researchers a range of improvements to stroke care is needed, including better access for non-urban residents to specialist stroke care units, improved support and coordination of care after discharge from hospital, better communication, and a focus on providing culturally safe care to M\u0101ori.\n                                                <\/p>\n<p>                                                                                The research is the first to make a systematic effort to ask stroke survivors from all over the country about their experiences of the health care system, including their acute care in hospital and their rehabilitation in the community.<\/p>\n<p>There are an estimated 9,000 strokes a year in New Zealand and this is expected to increase by 40% in the next decade.<\/p>\n<p>The researchers, from the University of Otago, University of Auckland and other partner organizations, are working on a Health Research Council (HRC) funded research project, REGIONS Care. They held 10 focus groups with stroke survivors across the country to explore their experiences, challenges, and how to overcome them. Their research is published in <i>The New Zealand Medical Journal<\/i>.<\/p>\n<p>The focus group study lead, Associate Professor Matire Harwood (Ng\u0101puhi) from the University of Auckland, says the patient-focused study identifies what is most important to people who have had strokes and their wh\u0101nau.<\/p>\n<p>Associate Professor Harwood says stroke survivors made many positive comments on the diagnostic process and their care in hospitals. But they also talked of negative experiences, including that the stroke care workforce <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/download-scripts-themes-apps\/\" data-internallinksmanager029f6b8e52c=\"9\" title=\"Download Scripts &amp; Themes &amp; Apps\" target=\"_blank\" rel=\"noopener\">app<\/a>eared to be &#8220;run off their feet&#8221; and were not always experts in the field.<\/p>\n<p>Many also mentioned not receiving enough information, particularly about why they had had a stroke. &#8220;When participants tried to request further investigations to understand the reasons behind their stroke, they felt their concerns were dismissed.&#8221;<\/p>\n<p>Several M\u0101ori and Pacific participants said they were perplexed by the limited number of M\u0101ori and Pacific hospital staff working in stroke services. When M\u0101ori doctors and other clinicians were available, M\u0101ori patients reported feeling safer and more at ease, saying there was already a connection between patient and clinician because of their shared culture. They stressed the importance of having doctors who spoke te reo M\u0101ori to help address cultural and language barriers.<\/p>\n<p>People who had experienced strokes also reported major gaps and inconsistencies in the community care received following their stroke, including in waiting times and access to therapy.<br \/>\n                                            <!-- Google middle Adsense block --><\/p>\n<p>The overall research program lead, Professor Anna Ranta from the Department of Medicine at the University of Otago, Wellington, comments: &#8220;Most waited one to two weeks for follow-up care, but others waited two to five months, so people felt they had not reached the full potential of their recovery, or had ended up paying for disability living aids themselves.&#8221;<\/p>\n<p>When available, specialist stroke units were <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/general\/\" data-internallinksmanager029f6b8e52c=\"3\" title=\"General\" target=\"_blank\" rel=\"noopener\">general<\/a>ly praised for their multi-disciplinary approach, their stroke expertise, and the coordination of care, Professor Ranta says.<\/p>\n<p>Previous research by the REGIONS Care researchers has found dramatic differences in stroke care access and post-stroke outcomes for non-urban New Zealanders and M\u0101ori.<\/p>\n<p>Their research, recently published in the international medical journals <i>Neurology<\/i> and <i>The Lancet Regional Health: Western Pacific<\/i>, found people presenting to non-urban hospitals had a 28\u201333% lower chance of being independent at three, six and 12 months and were 57% more likely to have died and nearly twice as likely to experience recurrent vascular events within 12 months.<\/p>\n<p>New Zealanders of non-European descent were 33\u201344% less likely to be physically independent at three, six and 12 months and M\u0101ori were 75% more likely to have died by 12 months. Both findings were independent of whether the person was living outside an urban area, meaning non-urban M\u0101ori were experiencing the worst outcomes overall, Professor Ranta says.<\/p>\n<p>Both at-risk populations also experienced worse access to key stroke interventions and Professor Ranta says this offers a clear pathway for improvement, with ongoing analysis showing major cost benefits from greater investment in hospitals outside the main centers.<\/p>\n<p>She says the differences in outcomes for M\u0101ori cannot be accounted for solely by differences in baseline risks, such as lifestyle or socioeconomic factors.<\/p>\n<p>&#8220;At least some of the differences are likely attributable to unconscious bias and institutional racism in the health service.&#8221;<\/p>\n<p>Professor Ranta says as a result of the findings, researchers are making concerted efforts to collaborate with M\u0101ori health providers and consumers, the Ministry of Health, the National Stroke Network and the Stroke Society of Australasia to develop education programs on cultural safety and to actively collaborate with M\u0101ori and non-urban stroke survivors to improve stroke care. In addition, district health board leadership teams are being sent individual DHB reports on their performance based on this research program to help with priority setting and monitoring of progress.\n                                                                                                                        <\/p>\n<hr\/>\n<div class=\"article-main__explore my-4 d-print-none\">\n<p>                                                                                        Significantly worse outcomes after stroke for rural New Zealanders and Maori, research finds\n                                                                                    <\/p><\/div>\n<hr class=\"mb-4\"\/>\n<div class=\"article-main__more p-4\">\n                                                                                                <strong>More information:<\/strong><br \/>\n                                                Barriers to optimal stroke service care and solutions: a qualitative study engaging people with stroke and their wh\u0101nau. <i>The New Zealand Medical Journal<\/i> (2022). <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/journal.nzma.org.nz\/journal-articles\/barriers-to-optimal-stroke-service-care-and-solutions-a-qualitative-study-engaging-people-with-stroke-and-their-whanau\">journal.nzma.org.nz\/journal-ar \u2026 oke-and-their-whanau<\/a><\/p>\n<p>Stephanie G. Thompson et al, The impact of ethnicity on stroke care access and patient outcomes: a New Zealand nationwide observational study, <i>The Lancet Regional Health\u2014Western Pacific<\/i> (2022).  <a rel=\"nofollow noopener\" target=\"_blank\" data-doi=\"1\" href=\"https:\/\/dx.doi.org\/10.1016\/j.lanwpc.2021.100358\">DOI: 10.1016\/j.lanwpc.2021.100358<\/a> <\/p>\n<p>Stephanie G Thompson et al, Geographic Disparities in Stroke Outcomes and Service Access: A Prospective Observational Study, <i>Neurology<\/i> (2022).  <a rel=\"nofollow noopener\" target=\"_blank\" data-doi=\"1\" href=\"https:\/\/dx.doi.org\/10.1212\/WNL.0000000000200526\">DOI: 10.1212\/WNL.0000000000200526<\/a><\/p><\/div>\n<div class=\"d-inline-block text-medium my-4\">\n                                                Provided by<br \/>\n                                                                                                    University of Otago<br \/>\n                                                                                                        <a rel=\"nofollow noopener\" target=\"_blank\" class=\"icon_open\" href=\"http:\/\/www.otago.ac.nz\/\"><br \/>\n                                                        <svg>\n                                                            <use href=\"https:\/\/medx.b-cdn.net\/tmpl\/v6\/img\/svg\/sprite.svg#icon_open\" x=\"0\" y=\"0\"\/>\n                                                        <\/svg><br \/>\n                                                    <\/a><\/p><\/div>\n<p>                                        <!-- print only --><\/p>\n<div class=\"d-none d-print-block\">\n<p>                                                 <strong>Citation<\/strong>:<br \/>\n                                                 Improving stroke care: What survivors say (2022, June 10)<br \/>\n                                                 retrieved 10 June 2022<br \/>\n                                                 from https:\/\/medicalxpress.com\/<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/news\/\" data-internallinksmanager029f6b8e52c=\"2\" title=\"News\" target=\"_blank\" rel=\"noopener\">news<\/a>\/2022-06-survivors.html<\/p>\n<p>                                            This document is subject to copyright. 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