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dc.contributor.authorPindus, Dominika M
dc.contributor.authorMullis, Ricky
dc.contributor.authorLim, Lisa
dc.contributor.authorWellwood, Ian
dc.contributor.authorRundell, A Viona
dc.contributor.authorAbd Aziz, Noor Azah
dc.contributor.authorMant, Jonathan
dc.date.accessioned2018-05-16T14:18:30Z
dc.date.available2018-05-16T14:18:30Z
dc.date.issued2018
dc.identifier.issn1932-6203
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/275849
dc.description.abstractOBJECTIVE: To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. DESIGN: Systematic review and meta-ethnography. DATA SOURCES: Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). ELIGIBILITY CRITERIA: Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. DATA SYNTHESIS: A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. RESULTS: 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. LIMITATIONS: Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. CONCLUSIONS: Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not have the knowledge or skills to re-engage. This can be addressed by: (1) increasing stroke specific health literacy by targeted and timely information provision, and (2) improving continuity of care between specialist and generalist services. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO 2015:CRD42015026602.
dc.format.mediumElectronic-eCollection
dc.languageeng
dc.publisherPublic Library of Science (PLoS)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectAttitude
dc.subjectAnthropology, Cultural
dc.subjectCaregivers
dc.subjectSurvivors
dc.subjectCommunity Health Services
dc.subjectPrimary Health Care
dc.subjectStroke
dc.titleStroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.
dc.typeArticle
prism.issueIdentifier2
prism.publicationDate2018
prism.publicationNamePLoS One
prism.startingPagee0192533
prism.volume13
dc.identifier.doi10.17863/CAM.23117
dcterms.dateAccepted2018-01-25
rioxxterms.versionofrecord10.1371/journal.pone.0192533
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-01
dc.contributor.orcidPindus, Dominika M [0000-0001-7288-7921]
dc.contributor.orcidMullis, Ricky [0000-0002-5129-290X]
dc.contributor.orcidLim, Lisa [0000-0002-3779-6095]
dc.contributor.orcidWellwood, Ian [0000-0002-6059-9209]
dc.contributor.orcidMant, Jonathan [0000-0002-9531-0268]
dc.identifier.eissn1932-6203
rioxxterms.typeJournal Article/Review
pubs.funder-project-idNational Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough Clinical Commissioning Group (CCG)) (unknown)
pubs.funder-project-idNational Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough Clinical Commissioning Group (CCG)) (PTC-RP-PG-0213-20001)
cam.issuedOnline2018-02-21


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International