1. Understanding Psychological Care on a Stroke Rehabilitation Unit
Birgit Gurr
Psychological care
refers to an approach to looking after the ill and injured that can be integrated with nursing or various therapies to add an organised and practical psychological content to overall care.
Keith Nichols’ model provided the theoretical underpinning for a survey of stroke rehabilitation staff’s understanding of psychological care.
The survey aimed to contribute to a formulation of psychological care issues on the stroke unit and requirements for service improvements in this field.
Why psychological care?
"In serious illness and injury, good psychological care complements and underpins physical treatment regimes. Psychological care contributes to recovery. When there is no psychological care, physical treatment plans may sometimes be undermined, and the power of medical, nursing and therapist interventions will be reduced!
(Nichols, 2003)
Survey
Stroke rehabilitation staff’s perceptions were investigated using a non-standardised questionnaire based on Nichols’ book.
All members of the Poole Hospital Stroke Care Unit:
nurses, doctors and therapists, but also managers, adminstrators and even the caretaker were approached to participate in the survey.
Questionnaires were returned by 28 of 57 team members. Questionnaire outcomes were analysed and categorised using qualitative study methods.
Awareness of Psychological Issues following Stroke
Patient-Centred Communication
Intervention
Emotional Care and Informational Care
Self-care by Staff
Psychological Assessment and/or Therapy
Levels of Psychological Care
Participants agreed that psychological care was relevant to their profession.
Psychological care duties were not systematically allocated to staff.
Highlights from Descriptive Analysis
Therapists (mainly) requested training about psychological issues following stroke.
Nurses (mainly) reported the need for improved self-care and a staff support group.
Three Themes from Qualitative Analysis
Implementation of the psychological care model
Systematic approach to monitor patients’ psychological well-being
Appropriate skills and interventions to optimise psychological well-being
Resources to consult with and refer to a psychological expert is essential for the maintenance of a psychological care system.
Training requirements
Education about stroke patients’ psychological issues is important
Training initiatives succeed if supported by the service manager / ward sister.
Psychological care for patients requires good self-care by staff
Understanding of psychological care
Interest in and Awareness of Patients’ psychological needs.
Selfawareness of Staff to meet these needs
procedures on the stroke unit.