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首页> 外文期刊>BMC Family Practice >Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists
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Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

机译：马来西亚公共卫生中心的中风后病人护理：家庭医生的自我报告做法

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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.
机译：背景技术服务的不协调和获得专业护理的机会有限，阻碍了发展中国家中风后护理的提供。尽管存在缺陷，初级保健仍在不利的情况下继续提供中风后服务。本文旨在审查在管理公共初级卫生保健服务的家庭医学专家中提供中风后护理和相关问题的方法。方法在一项试点调查中，向服务于公共资助卫生中心的121位家庭医生分发了半结构化问卷，其重点是改善社区一级的卒中后护理。该问卷评估了受访者的背景和实践细节，即估计的中风护理负担，当前的服务提供以及对服务改善的看法。均值和频率描述了定量数据。对于定性数据，使用恒定比较方法，直到达到主题饱和为止。结果获得48.8％的回应率。每月在公共卫生中心每100名患者中就有2名中风。每月看中风患者的中位数为5（IQR 2-10）。 57.6％的受访者估计，每个中心每年治疗的中风患者总数少于40名患者。尽管有96.6％的人同意需要一个标准的护理计划，但仍有72.4％的人没有标准的护理计划。所观察到的患者包括：三级护理中出院（88.1％），与专家共享的护理计划（67.8％），以及在初级保健中随访时发生中风的患者（64.4％）。随访时间为8-12周（60.3％），“按需”基础上为3.4％。按频率排序的转诊对象是公共设施中的理疗服务，营养师，言语和语言病理学家。 FMS认为在初级保健级别管理中风患者有4个重要的“需求”。获得康复服务，采用多学科护理方法，三级中心与初级护理之间的协调护理，标准化指南以及家庭和护理人员支持。结论对于居住在社区中的卒中后患者，需要出院后卒中治疗指南和初级保健中的康复服务。

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