Unmet needs in long-term outpatient rehabilitative care: a qualitative and multi-perspective study in Japan

Purpose This study explores the experiences and unmet needs related to post-discharge long-term rehabilitation from triadic perspective of male patients with stroke, caregivers, and rehabilitation professionals. Methods This is an exploratory qualitative study using in-depth interviews conducted in two outpatient rehabilitation facilities in Japan. Nine male patients with stroke, ten caregivers, and five rehabilitation professionals participated in this study. The data were coded, followed by thematic analysis. Results Patients who did not achieve further physical recovery regardless of their efforts experienced a loss of motivation and lost sight of their goals. Moreover, caregivers regarded such patients as lazy and reported feeling frustrated with them. Furthermore, patients and caregivers had unmet needs regarding communication with professionals and psychological and emotional care. In contrast, professionals perceived time constraints on outpatient rehabilitation service provision and sometimes narrowed the scope of the care approach to physical function aspects for providing services efficiently. They also expressed difficulties in identifying patients' needs, values, and meaningful goals. Conclusions These findings suggest that in Japanese post-stroke outpatient rehabilitation, there is a need to adopt a comprehensive care approach, enhance the quality of communication, and involve caregivers in the rehabilitation process in limited-resource situations.

Automated summary

This study investigates the experiences and unmet needs of male stroke patients, caregivers, and rehabilitation professionals in post-discharge long-term rehabilitation. The study reveals that patients who do not achieve further physical recovery may lose motivation and sight of their goals, while caregivers may view them as lazy and feel frustrated. Both patients and caregivers have unmet needs in terms of communication with professionals and psychological and emotional care. Professionals, on the other hand, face time constraints and may focus primarily on physical function aspects for efficient service provision.