Journal
DISABILITY AND REHABILITATION
Volume 43, Issue 20, Pages 2897-2908Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2020.1722263
Keywords
Stroke; caregivers; family; adaptation; psychological; goals; qualitative research
Categories
Funding
- PROTEC - Programa de Apoio a Formacao Avancada de Docentes do Ensino Superior Politecnico (literally Programme to Support the Advanced Studies of Higher Education Teachers) - Portuguese Government Directorate of Higher Education
- Polytechnic Institute of Setubal [SFRH/PROTEC/67867/2010]
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The study highlights the shifting perspectives of stroke survivors and carers as they adapt at home, with changes in roles, expectations, and future plans. It emphasizes the importance of team involvement and the need for professionals to adjust their approach based on the evolving needs and expectations of stroke survivors and carers.
Aim: To understand how people with stroke and carers adapt over time, and how health professionals support transition to home. Method: A multi-perspective, prospective, qualitative, longitudinal study was conducted using in-depth semi-structured interviews one and six months after inpatient discharge. Twenty-four participants (eight triads, including people with stroke, carers and health professionals) were included. Thematic and narrative analysis facilitated identification of cross-cutting themes according to individual trajectories post-stroke. Findings: A major theme: regaining control of life suggested a shift in perspective after six months at home. Four sub-themes help to understand the triads' perspectives over time: i) importance of team involvement; ii) differences in perceived roles within the triad; iii) differences in expectations and collaboration within the triad and iv) planning a different future. People who were involved in supporting adaptation and rehabilitation processes were reported differently between triads and over time, showing the complexity of interrelations. A reduction in professional involvement was matched by changes in participants' goals and expectations. Conclusion: Findings suggest the importance of a dyadic perspective and a gradual increase in people with stroke and carers' active engagement. Professionals' approach throughout rehabilitation should be modified according to people with stroke and carers' changing needs and expectations.
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