Abstract WP364: Key Stakeholders Recognize the Need for a Structured Approach to Psychological Support with Input from a Clinical Psychologist
Background: International guidelines recommend the routine assessment and management of mood and cognition post-stroke. However there is no consensus regarding the optimal method of assessment and a recent audit demonstrated limited access to clinical psychologists in England. Recent UK guidelines promote a structured approach to psychological care with the level of input and expertise corresponding to need. The purpose of this study was to explore patients’, carers’ and health professionals’ experiences of the psychological support delivered and received post-stroke.
Methods: Thirty-two semi-structured interviews were conducted with dyads of patients (n=31) and carers (n=28). Eight focus groups and 9 interviews were conducted with stroke care health professionals (n=66), including a variety of disciplines and grades from 7 UK centres. The interviews were recorded and transcribed verbatim, and analysed using thematic analysis.
Results: Three themes emerged: lack of availability of psychological support and clinical psychologists; factors mediating the need for psychological support; benefits of a structured approach. Lack of psychological services post-stroke resulted in reliance on medication and other disciplines assuming the role of a psychologist without the required expertise. Some patients perceived psychological support to be synonymous with information provision, which they wanted to provide reassurance. Factors perceived to mediate the need for psychological support included: the attitude and personality of the patient, availability of social support, downward social comparison with other stroke survivors and the patient’s age. Staff highlighted the benefits of a structured approach to psychological care, but some degree of clinical psychology input was essential.
Conclusions: Despite awareness of the limited access to psychological support for stroke patients in England, results suggest little is being done to address the deficit. If a structured approach is to be used effectively nurses and therapists need further training and some degree of clinical psychology input must be made available.
- © 2012 by American Heart Association, Inc.