Challenges and patient strategies in seeking health services for chronic stroke: A qualitative study

Yu Chen, S. Park, Xinning Gui, Steven C. Cramer, Kai Zheng, Yunan Chen
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Abstract

Objective: Previous healthcare informatics research identifies a critical need for information technologies to support the selfmanagement of chronic illness by patients and caregivers. However, little is known about their experiences and challenges in seeking health services.Methods: We present a qualitative study with chronic stroke patients and their caregivers. Among them the 13 patients who participated in the study, 9 patients also participated together with a caregiver, who played a major role in helping the patients seek health services and the other 4 stroke patients, who dealt with stroke management independently, participated in the study by themselves. We used a grounded theory approach to analyze the interview data.Results: Our findings revealed three main barriers that stroke patients and their caregivers faced in utilizing affordable, accessible, and satisfactory health services and the corresponding strategies they adopted to cope with these challenges.Conclusions: We discussed that these strategies reflect patients’ creative appropriation in making services affordable and could inform technology design that builds around patients’ creation. In addition, patients’ collaborative and yet onerous strategies to access health services imply the opportunities of designing technologies that leverage local social resources. Moreover, to offer satisfactory health services, it is valuable to provide individualized treatment plans that consider patients’ treatment goals, symptoms, and home environment. The findings could apply to similar neurological diseases that require long-term rehabilitation.
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慢性中风患者寻求医疗服务的挑战和策略:一项定性研究
目的:先前的医疗信息学研究确定了对信息技术的迫切需求,以支持慢性疾病患者和护理人员的自我管理。然而,人们对她们在寻求保健服务方面的经历和面临的挑战知之甚少。方法:对慢性脑卒中患者及其护理人员进行定性研究。在13例参与研究的患者中,9例患者与护理人员一起参与研究,护理人员在帮助患者寻求健康服务方面发挥主要作用,另外4例卒中患者独立处理卒中管理,自行参与研究。我们使用扎根理论的方法来分析访谈数据。结果:我们的研究结果揭示了中风患者及其护理人员在利用负担得起的、可获得的和令人满意的卫生服务方面面临的三个主要障碍,以及他们采取的应对这些挑战的相应策略。结论:我们讨论了这些策略反映了患者在使服务负担得起方面的创造性挪用,并可以为围绕患者创造的技术设计提供信息。此外,患者获得医疗服务的协作性和繁重的策略意味着设计利用当地社会资源的技术的机会。此外,为了提供满意的健康服务,提供个性化的治疗方案,考虑患者的治疗目标、症状和家庭环境是有价值的。这一发现可能适用于需要长期康复的类似神经系统疾病。
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