Objective: To explore the views of therapists working with stroke patients on the use of a patient-held record (PHR) for stroke patients. A PHR was developed in the form of a pocket-sized booklet (21 cm × 14.5 cm) in which staff recorded information relating to the patient's management. The aim of the PHR was to facilitate communication and involve patients more directly in their care.
Methods: Six semi-structured group interviews were conducted with therapists (25 in total) from one inner city hospital.
Results: The following themes emerged from the content analysis: (1) Therapists were supportive of plans for a PHR, citing the benefits of greater patient involvement. (2) However, they questioned its feasibility, in particular the issue of patient responsibility and its use with the cognitively impaired. (3) They also questioned its ability to facilitate communication among health professionals because of existing differences in perspectives. (4) These therapists revealed concerns about the effect that information may have on patients. (5) They also raised practical issues about finding the time to make entries, wording and content of entries in the PHR.
Conclusion: Responsibility for the PHR may enhance patients' understanding and involvement in their care, yet ownership alone does not guarantee the confidence needed to encourage dialogue between patients and care providers. Furthermore, it is doubtful whether a PHR can hope to overcome the fundamental differences in the philosophies of care which the therapists reported.
Get full access to this article
View all access options for this article.
References
1.
King's Fund Consensus Statement Treatment of Stroke . BMJ1988; 297: 126–128 .
2.
Pound P , Gompertz P , Ebrahim S . Patient's satisfaction with stroke services . Clin Rehabil1994; 8: 717-717 .
3.
Elbourne D , Richardson M , Chalmers I et al. The Newbury Maternity Care Study: a randomised controlled trial to evaluate a policy of women holding their own obstetric records . Br J Obstet Gynaecol1987; 94: 612-619 .
4.
Lovell A , Zander LI , James CE et al. The St Thomas's Maternity Case Notes study: a randomised controlled trial to assess the effects of giving expectant mothers their own maternity case notes . Paediatr Perinat Epidemiol1987; 1: 57–66 .
5.
Sheldon MG . Giving patients a copy of their computer medical record . J R Coll Gen Pract1982; 32: 80–86 .
6.
Metcalf DHH . Why not let patients keep their own records?J R Coll Gen Pract1980; 30: 420-420 .
7.
Essex B , Doig R , Renshaw J . Pilot study of records of shared care for people with mental illnesses . BMJ1990; 300: 1442–1446 .
8.
Gilbert N . Researching social life. London: SAGE Publications , 1993.
9.
Strauss A , Corbin J . Basics of qualitative research. Grounded theory, procedures and techniques. London: SAGE Publications , 1990.
10.
Gibbon B , Little V . Improving stroke care through action research . J Clin Nurs1995; 4: 93–100 .
11.
Waters KR , Luker KA . Staff perspectives on the role of the nurse in rehabilitation wards for elderly people . J Clin Nurs1996; 5: 105–114 .
12.
Ehrenreich B , Ehrenreich J . Medicine and social control. In: Ehrenreich J ed. The cultural crisis of modern medicine. New York: Monthly Review Press , 1978: 39–79.
13.
Freidson E . The profession of medicine, second edition. London: University of Chicago Press , 1988: 64–80.
14.
Seale C . The consumer voice. In: Davey B , Popay J eds. Dilemmas in health care. Milton Keynes: Open University Press , 1993.
15.
Salvage J . The new nursing: empowering patients or empowering nurses? In: Robinson J ed. Policy issues in nursing. Milton Keynes: Open University Press , 1991: 9–23.
16.
Department of Health . The patient's charter. London: HMSO , 1991.
17.
Lowry M . Knowledge that reduces anxiety – creating patient information leaflets. Prof Nurse1995; February: 318–320.
18.
Pound P , Bury M , Gompertz P , Ebrahim S . Views of survivors of stroke on benefits of physiotherapy . Qual Health Care1994; 3: 69–74 .
19.
Davis F . Passage through crisis. Indianapolis: Bobbs-Merrill , 1963.
20.
Hoffman JE . “Nothing can be done”: social dimensions of the treatment of stroke patients in a general hospital . Urban Life Culture1974; 3(1): 50–70 .
21.
Reid M , Garcia J . Women's views of caring during pregnancy and childbirth. In: Chalmers I , Enkin M , Keirse M eds. Effective care in pregnancy and childbirth. Oxford: Open University Press , 1989.
22.
Veers HK . Multidisciplinary teams in geriatric wards: myth or reality?J Adv Nurs1981; 6: 205–214 .
23.
Pound P , Ebrahim S . Redefining ‘doing something': health professionals' views on their role in the care of stroke patients . Physiother Res Int1997; 2: 12–28 .
