A qualitative description of barriers to visual rehabilitation experienced by stroke survivors with visual impairment in Alberta, Canada

BMC Health Services Research

Research

Jennis Jiang¹  Karim F. Damji²  Katelyn Brehon³  Fiona Costello⁴  Kiran Pohar Manhas⁵ 

[1] Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Ophthalmology and Visual Sciences, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada;Department of Ophthalmology and Visual Sciences, Aga Khan University, Karachi, Pakistan;Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada;Departments of Clinical Neurosciences and Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Neurosciences, Rehabilitation and Vision, Strategic Clinical NetworkAlberta Health Services, 10301 Southport Lane SW, T2W 1S7, Calgary, AB, Canada;Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada;

关键词: Stroke;    vision loss;    qualitative;    patient experience;    provider experience;   

DOI  :  10.1186/s12913-023-09064-9

 received in 2022-09-08, accepted in 2023-01-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPost-stroke visual impairment (VI) is a common but under-recognized care challenge. Common manifestations of post-stroke VI include: diplopia, homonymous hemianopia, oscillopsia secondary to nystagmus, and visual inattention or neglect. In acute care settings, post-stroke VI recognition and treatment are often sub-optimal as emphasis is placed on survival. Stroke survivors with VI often face inconsistencies when accessing care out of hospital because variable availability and subsidization of visual rehabilitation. We sought to identify gaps in care experienced by stroke survivors with VI from stroke survivors’ and care providers’ perspectives.MethodsWe conducted a qualitative description study across 12 care sites in Alberta, Canada, using semi-structured interviews. Survivor interviews focused on the health system experience. Provider interviews discussed approaches to care, perceived gaps, and current resources. Interviews were audio-recorded and transcribed. Iterative content analysis was completed using NVivo 12. We promoted rigour through an audit trail, open-ended questions, thick description, and collaborative coding.ResultsWe completed 50 interviews: 19 survivor interviews and 31 provider interviews. The majority of survivors were male (n = 14) and recruited from community settings (n = 16). Providers varied in profession and location within the care continuum. Two key themes emerged from the provider and survivor interviews pertaining to (a) facets of visual rehabilitation (sub-themes: access, resources, and multidisciplinary professional interaction); and (b) functioning with post-stroke VI (sub-themes: early experiences post-stroke and living with VI in the real world).ConclusionsThe visual rehabilitation model needs to be optimized to ensure transparent inter-disciplinary communication and efficient referral pathways. Future research will focus on evaluating the effectiveness of post-stroke care from multiple perspectives in Alberta.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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