Experiences of healthcare providers, survivors and caregivers with hospital-to-home stroke transitional care in Tanzania: a qualitative study

坦桑尼亚医护人员、卒中幸存者及其照护者在医院到家庭过渡期护理方面的经验:一项定性研究

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Abstract

OBJECTIVE: To explore experiences of healthcare providers, stroke survivors and caregivers on stroke transitional care delivery at a tertiary hospital in Tanzania. DESIGN: A qualitative descriptive design with a phenomenological approach was used. Colaizzi's thematic analysis was conducted using Dedoose software to identify significant information that describes the transitional care experiences of the study participants. SETTING: This study was conducted in the internal medicine and outpatient departments of a tertiary hospital in Tanzania. PARTICIPANTS: 15 triads of healthcare providers, stroke survivors and caregivers were purposively recruited to participate in semi-structured in-depth interviews between June and September 2024. RESULTS: The analysis identified four themes: communication and exchange of information, involvement of patients and caregivers in transitional care, coordination of transitional care and experiences with changing care setting. Effective communication and information exchange among healthcare providers, survivors and caregivers ensured that survivors and their caregivers were well informed about the care process, clinical condition, prognosis and transitional care needs. A collaborative care approach enabled survivors and caregivers to actively participate in care, decision-making and discharge planning during hospital-to-home transition. Coordination of care was equally important during hospital-to-home transition as it provided survivors with home-care instructions and opportunities for follow-up care. However, miscommunication among the healthcare team, insufficient information exchange, inadequate discharge planning, poor social support and lack of care coordination prevented smooth hospital-to-home transition leading to a crisis at home. CONCLUSIONS: The experiences of healthcare providers, patients and caregivers during stroke transitional care in Tanzania highlight achievements and key areas for improvement. Hospital-to-home transition is often characterised by uncertainty and emotional strain, emphasising the need for effective communication, involving patients and caregivers in care, as well as coordinating transitional care to address medical and psychosocial needs of survivors and their caregivers during and after discharge.

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