Education and Ethics In Nursing ISSN: 2322-5300

Localization of clinical guidelines for home care of elderly patients with stroke: A Study Protocol

https://doi.org/10.22034/ethic.2025.2043957.1137
Volume 13, special issue
July 2024
Pages 173-183
Education and Ethics In Nursing ISSN: 2322-5300

Document Type : protocol study

Authors

Mahrokh keshvari 1
Simin Safiri 2
Tayebeh Karimi 3
Maryam Hashemi 4

1 Associate Professor of Nursing Department of Community Health Nursing, School of Nursing and Midwifery Nursing and Midwifery Care Research Center Isfahan University of Medical Sciences, Isfahan, Iran

2 Senior Pediatric Nursing Expert, Amin Hospital, Isfahan, Iran

3 Assistant Professor of Nursing Department of Community Health Nursing, School of Nursing and Midwifery Isfahan University of Medical Sciences

4 Assistant Professor, Nursing and Midwifery Care Research Center , Departments of Critical Care Nursing , Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
Introduction:
Clinical guidelines for home care of elderly stroke patients is a missing link in providing home care services in Iran, which can play an important role in improving the health and rehabilitation of stroke patients. This is despite the fact that compiling clinical guidelines in Iran will be very difficult, and by localizing existing clinical guidelines, rework can be prevented and resources can be saved. Therefore, this study is carried out with the aim of "localization of clinical guidelines for home care of elderly patients with stroke".
Method:
The current research includes three steps of preparation, localization and finalization. The first step (preparation) includes 5 steps (checking the ability of carrying out the localization process, forming the executive committee, choosing the title of the guide, identifying and determining the necessary resources, facilities and skills and writing the program localization process), the second step (localization) including 5 steps (choosing  questions, searching for guidelines and other relevant evidence, screening the found guidelines and limiting them, reviewing evaluations and selecting guidelines and preparing a draft of localized clinical guidelines) and the third step ( finalization  guideline) including 2 Steps (external review by target users  and compiling the final guide with the consensus of experts and the use of the RAM technique).
Discussion: 
In order to localize clinical guidelines, first research team should review similar clinical guidelines by appropriate keywords and select the best guidelines. Then, experts and stakeholders should be revised guideline based on cultural, economic, and social conditions and available facilities. So that they can be implemented in the country.

Keywords

Guideline
Home Care
Elderly
Stroke
Subjects

  1. 1.Heran M, Lindsay P, Gubitz G, Yu A, Ganesh A, Lund R, et al. Canadian stroke best practice recommendations: acute stroke management, practice guidelines update, 2022. Canadian Journal of Neurological Sciences 2024;51(1):1-31.

    2.Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. International Journal of Stroke 2022;17(1):18-29.

    3.Ghandehari K. Epidemiology of stroke in Iran. Galen Medical Journal 2016;5(S1):3-9.

    4.Soleimanzadeh-Ardabili N, Vahdat I, Abdollahi I, Rostami M. Evaluation of spasticity variations at the elbow joint of CVA patients according to the biomechanical indices. Archives of Rehabilitation 2013;14(3):96-106.

    5.Schwarz A, Bhagubai MM, Nies SH, Held JP, Veltink PH, Buurke JH, et al. Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures. Journal of neuroengineering and rehabilitation 2022;19:1-18.

    6.Schindel D, Schneider A, Grittner U, Jöbges M, Schenk L. Quality of life after stroke rehabilitation discharge: a 12-month longitudinal study. Disability and Rehabilitation 2021; 43(16):2332-41.

    7.Zhang X, Bi X. Post-stroke cognitive impairment: a review focusing on molecular biomarkers. Journal of Molecular Neuroscience 2020; 70:1244-54.

    8.Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: a 2020 updated review. General hospital psychiatry 2020;66:70-80.

    9.Ytterberg C, Cegrell L, von Koch L, Wiklander M. Depression symptoms 6 years after stroke are associated with higher perceived impact of stroke, limitations in ADL and restricted participation. Scientific Reports 2022; 12(1):7816.

    10.Marin S, Serra-Prat M, Ortega O, Clavé P. Healthcare-related cost of oropharyngeal dysphagia and its complications pneumonia and malnutrition after stroke: a systematic review. BMJ open 2020; 10(8):e031629.

    11.Joundi RA, Smith EE, Yu AY, Rashid M, Fang J, Kapral MK. Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke. Neurology 2021; 96(16):e2037-e47.

    12.Vluggen TP, van Haastregt JC, Tan FE, Kempen GI, Schols JM, Verbunt JA. Factors associated with successful home discharge after inpatient rehabilitation in frail older stroke patients. BMC geriatrics 2020;20:1-8.

    13.Mountain A, Patrice Lindsay M, Teasell R, Salbach NM, de Jong A, Foley N, et al. Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke. Part two: transitions and community participation following stroke. International Journal of Stroke 2020;15(7):789-806.

    14.Siavashi E, Kavosi Z, Zand F, Amini M, Bordbar N. Inappropriate hospital stays and association with lack of homecare services. Eastern Mediterranean Health Journal 2021; 27(7):656-64.

    15.Wani S, Sultan S, Qumseya B, Michalek J, Dewitt J, Edmundowicz SA, et al. The ASGE’S vision for developing clinical practice guidelines: the path forward. Gastrointestinal Endoscopy 2018;87(4):932-3.

    16.Shekelle PG. Clinical Practice Guidelines: What’s Next?Key Issues in the Development of Clinical Practice GuidelinesKey Issues in the Development of Clinical Practice Guidelines. JAMA 2018;320(8):757-8.

    17.Juckett LA, Wengerd LR, Faieta J, Griffin CE. Evidence-based practice implementation in stroke rehabilitation: a scoping review of barriers and facilitators. The American Journal of Occupational Therapy 2020; 74(1):7401205050p1-p14.

    18.Teasell R, Salbach NM, Foley N, Mountain A, Cameron JI, Jong Ad, et al. Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; update 2019. International Journal of Stroke. 2020;15(7):763-88.

    19.Harrison MB, Graham ID, Van Den Hoek J, Dogherty EJ, Carley ME, Angus V. Guideline adaptation and implementation planning: a prospective observational study. Implementation science 2013;8(1):49.

    1. Andersen BL, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology 2014;32(15):1605.
    2. Chakraborty SP, Jones KM, Mazza D. Adapting lung cancer symptom investigation and referral guidelines for general practitioners in A ustralia: Reflections on the utility of the ADAPTE framework. Journal of evaluation in clinical practice 2014; 20(2):129-35.
    3. Abdel Baky A, Fouda EM, Hussein SM, Sobeih AA, Abd Al Razek AM, Hassanain AI, et al. Bronchiolitis diagnosis, treatment, and prevention in children: an evidence-based clinical practice guideline adapted for the use in Egypt based on the ‘Adapted ADAPTE’Methodology. Egyptian Pediatric Association Gazette 2022; 70:1-9.
    4. AGREE Next Steps Consortium. The AGREE II Instrument: Update 2013 [Available from: http://www.agreetrust.org.
    5. Te Brake H, Willems A, Steen C, Dückers M. Appraising evidence-based mental health and psychosocial support (MHPSS) guidelines—PART I: A systematic review on methodological quality using AGREE-HS. International Journal of Environmental Research and Public Health 2022; 19(5):3107.
    6. Rashidian A, Yousefi‐Nooraie R. Development of a Farsi translation of the AGREE instrument, and the effects of group discussion on improving the reliability of the scores. Journal of Evaluation in Clinical Practice 2012; 18(3):676-81.
    7. Jandhyala R. Delphi, non-RAND modified Delphi, RAND/UCLA appropriateness method and a novel group awareness and consensus methodology for consensus measurement: a systematic literature review. Current Medical Research and Opinion 2020;36(11):1873-87
    8. 27. van der Ploeg MA, Poortvliet RK, Achterberg WP, Mooijaart SP, Gussekloo J, Drewes YM. Assessment of the appropriateness of cardiovascular preventive medication in older people: using the RAND/UCLA Appropriateness Method. BMC geriatrics 2022;22(1):1-10.
    9. 28. Lim L, Mant J, Mullis R, Roland M. When is referral from primary care to specialist services appropriate for survivors of stroke? A modified RAND-appropriateness consensus study. BMC Family Practice. 2020;21:1-10.
    10. Harrison MB, Graham ID, Van Den Hoek J, Dogherty EJ, Carley ME, Angus V. Guideline adaptation and implementation planning: a prospective observational study. Implementation science 2013;8(1):49.
    11. Andersen BL, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology 2014;32(15):1605.
    12. Chakraborty SP, Jones KM, Mazza D. Adapting lung cancer symptom investigation and referral guidelines for general practitioners in A ustralia: Reflections on the utility of the ADAPTE framework. Journal of evaluation in clinical practice 2014;20(2):129-35.

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