Nurses' perceptions and experiences at daycare for elderly with stroke

Purpose: While adult daycare (ADC) is considered a culturally acceptable model of long-term care in countries with a tradition of family-oriented caregiving, Korea is struggling as soaring needs for ADC outpace qualified staff and regulatory systems. This study aimed to describe Korean daycare nurses' perceptions of key daycare services and their working experiences with stroke patients and their families. Design: A mixed-method design was used. First, we conducted a cross-sectional descriptive survey to assess Korean nurses' perceptions about the importance of daycare services. Then focus group interviews were performed to explore the nurses' experiences at ADC. Methods: Seventy of a total of 96 nurses at ADC that specialized in the care of stroke patients responded to the survey (response rate 72.9%) and rated the importance of 11 key daycare service items on a visual analogue scale (0-10). Using a purposive sampling design, 16 eligible nurses were interviewed as a group. The qualitative data from focus group interviews were analyzed using thematic analysis to classify common themes into larger categories. Findings: Survey data revealed that the nurses perceived "skilled nursing services," "functional recovery," and "general health counseling" as the most important daycare service areas. Focus group data resulted in five themes: "Providing the same, standard care," "Lack of partnership with family caregivers," "Conflict with other staff: ambiguity of the roles and tasks," "Lack of proper education and training," and "Need for quality control and monitoring." Conclusions: Daycare nurses fully recognized the importance of direct nursing care services that are keys to adequate recovery and rehabilitation of older patients with stroke. However, they experienced substantial barriers to carrying out these services due to role confusion, insufficient number of qualified nursing staff, and lack of partnership with family caregivers. Clinical Relevance: The results provide insight into changing healthcare policy to support daycare nurses in a country with limited resources and regulations. Strategies such as better quality control and monitoring of daycare services, provision of continuing education, and prioritizing key services should be considered as a way to address challenges experienced by daycare nurses.