Care for post-stroke patients at Malaysian public health centres : a self-reported practices of family medicine specialists

Abdul Aziz, Aznida F., Mohd Nordin, Nor A., Abd Aziz, Noor, Abdullah, Suhazeli, Sulong, Saperi and Aljunid, Syed M., (2014). Care for post-stroke patients at Malaysian public health centres : a self-reported practices of family medicine specialists. BMC Family Practice, 15(40), 1471-2296

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  • Sub-type Journal article
    Author Abdul Aziz, Aznida F.
    Mohd Nordin, Nor A.
    Abd Aziz, Noor
    Abdullah, Suhazeli
    Sulong, Saperi
    Aljunid, Syed M.
    Title Care for post-stroke patients at Malaysian public health centres : a self-reported practices of family medicine specialists
    Appearing in BMC Family Practice
    Volume 15
    Issue No. 40
    Publication Date 2014-03-02
    Place of Publication London
    Publisher BioMed Central
    Start page 1471
    End page 2296
    Language eng
    Abstract

    Background

    Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services.

    Methods

    A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached.

    Results

    Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support.

    Conclusions

    Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community.

    Keyword Post stroke
    Primary care
    Healthcare delivery
    Copyright Holder The Authors
    Copyright Year 2014
    Copyright type Creative commons
    DOI 10.1186/1471-2296-15-40
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    Created: Tue, 29 Sep 2015, 12:34:50 JST