Background and Purpose:
Our previous study of 265 stroke survivors recruited immediately before discharge from two regional rehabilitation hospitals found state self-esteem, social support satisfaction, discharge location (home, residential care facility), and gender significantly accounted for 49% of the variance in depressive symptoms. The purpose of this study is to explore the challenges of promoting participation in life activities for stroke survivors.
Methods:
A qualitative study with individual face-to-face semi-structured interviews were conducted. Adult managerial persons who were responsible for the development of community, rehabilitation or residential care services for stroke survivors were recruited. All participants were asked to share the mission of their institutions, types of care services for stroke survivors, perceived importance of, barriers to and facilitators of promoting participation in life activities, and opportunities for enhancing stroke care services. All interviews were audio recorded and transcribed verbatim for thematic analysis.
Results:
A total of 11 participants were interviewed. Five were in-charge persons of stroke support groups, two were legislators, two from residential care facilities, and two from community-based organisations. Four key themes were generated: (1) Being institutionalized was found associated with lower levels of psychosocial health, (2) Stroke survivors’ physical and cognitive limitations were perceived as key challenges in promoting participation in life activities, (3) Healthcare providers placed more emphasis on promoting physical rehabilitation than social participation, and (4) Physical environment particularly in residential care facilities posed greater challenges to promoting participation in real life activities.
Conclusions:
This highlights major challenges for healthcare professionals who care for stroke survivors in residential care facilities. Further studies that investigate the associations between environmental barriers, psychological morbidity and participation restriction is needed.