Developing a stroke-vision care pathway: a consensus study

Abstract

Purpose

We aimed to develop a stroke-vision care pathway for stroke survivors with visual impairment.

Methods

A literature review searched key electronic bibliographic databases for care pathways related to stroke/vision. Two focus group meetings using semi-structured/nominal group technique reached consensus on items relevant for inclusion in a stroke-vision care pathway. Following the development of the pathway, we obtained feedback through consultation with patient and professional groups.

Results

The literature review identified two care pathways relevant to acute stroke and generic vision disorders. Outputs from focus groups related to how stroke survivors present with vision problems; the time points at which stroke survivors present with vision symptoms; the relevance of different types of visual condition to different vision services; the importance of support services supplementary to hospital services and; the importance of key resources to promote awareness of vision problems in stroke survivors. Refinement of the pathway considered time duration from stroke onset, reporting of symptoms to services, and signposting/referrals required dependent on visual condition type.

Conclusions

This new stroke-vision care pathway is a process pathway describing potential options for stroke survivors with visual impairment to access health care and obtain appropriate referral(s) to vision services relevant to their specific vision problem(s).

IMPLICATIONS FOR REHABILITATION

• Visual impairment is a common consequence of stroke.

• It is imperative that those who care for stroke survivors are aware of the visual consequences of stroke and make the appropriate referrals for vision and support services.

• The stroke-vision care pathway is a process pathway that describes the potential options for stroke survivors with visual impairment to access health care and obtain the appropriate referral(s) to vision services relevant to their specific vision problem(s).

• The stroke-vision care pathway is available (free to download) from the VISION research unit (www.vision-research.co.uk) website and available as supplemental information with this publication.

Keywords:

• Care pathway
• stroke
• vision
• service provision
• referral
• detection

Author contributions

FR provided oversight for the study and led the writing of the paper. FR, LH, CH, BH, and KH contributed to data collection, reviewing the draft paper and approving the final version.

Acknowledgements

We thank the stroke survivors, carers, and clinicians who contributed to the development of this care pathway.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Professor Fiona Rowe was funded by a National Institute for Health Research (NIHR) Career Development Fellowship for this research project. This paper presents independent research funded by NIHR. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.