(Abstract only) Regional Differences in Post-discharge Stroke Care in India: A Qualitative Study

Abstract

Background: Stroke is the fourth leading cause of death and fifth leading cause of disability in India. Stroke
rehabilitation can reduce mortality and improve outcomes, but India has limited resources to provide
comprehensive stroke care after hospitalisation. Consequently, stroke survivors and family carers experience
a range of challenges with long-term care and support. Secondary prevention and stroke rehabilitation services
are important in post-discharge stroke care; however, there is insufficient information on post-discharge stroke
services in India.
Aim: This study aims to explore the clinical staff perspectives of post-discharge stroke services across different
regions of India.
Methods: Semi-structured interviews were undertaken with a purposive sample of health professionals from
multidisciplinary stroke teams at the All India Institute of Medical Sciences, New Delhi (North), Baptist
Christian Hospital (North-East), Sree Chitra Tirunal Institute for Medical Sciences and Technology (South)
between July and August 2021. The interviews were conducted, translated, and transcribed by the research
team. Data were analysed thematically using NVivo software.
Results: Twenty-six health professionals participated: 9 Nurses, 7 Doctors, 5 Physiotherapists, 2 Speech and
Language Therapists, and 1 Social Worker, Dietician, and Palliative Care team member. Four themes were
identified: Integrated Inpatient Discharge Care Planning; Patient and Caregiver Engagement; Post-Discharge
Care and Support; Resources and Workforce.
Conclusion: Patient and caregiver engagement is an integral part of post-discharge processes; however,
regional variation exists in the discharge planning, staff, resources, and services available for post-discharge
support. Moreover, patient and caregiver challenges vary across geographical locations, educational
backgrounds, financial status, family, and support networks.