Background:
Stroke is a leading cause of disability worldwide. Stroke survivors living in the community require regular, ongoing, and coordinated services to prevent deterioration and maximize health outcomes. Published evidence, often conducted in large urban centres, suggests that community reintegration services are an important component of care for stroke survivors. This evidence, however, often does not address the particular challenges inherent in servicing stroke survivors who reside in smaller urban and rural contexts.
Purpose:
The purpose of this study was to gain an understanding of the priorities that are needed to support stroke recovery and community reintegration from the perspectives of survivors and service providers living in four geographic districts in Northeastern Ontario, Canada.
Methods:
Using Q methodology, 45 service providers, and 43 stroke survivors and their family caregivers ranked 30 theoretical statement cards. Each card identified a feature specific to stroke recovery, community navigation and community reintegration. These statements were generated through a review of health care literature and qualitative data collected from interviews with stroke survivors. Q analysis of the priority ranked statements involved centroid factor analysis and varimax rotation.
Results:
The three discrete viewpoints of survivors were Role of Skilled Navigators, Survivors as Co-navigators, and Striving for Well-being. The survivors’ consensus perspective, labelled Quality Service, identified the importance of timeliness and appropriateness of service. The three discrete viewpoints for service providers were Role of Skilled Navigators, Survivor-centered Practices, and Optimizing Survivors’ Resources. The consensus perspective of service providers was labelled Involvement of Family Carers. Findings were consistent across all 4 geographic districts.
Conclusion:
This research suggests that survivors’ and providers’ conceptualized role of community navigators is focused on building upon the strengths and capacity of survivors through cooperative inquiry with multiple stakeholders. A time-sensitive, appropriate, and family involved service structure supports survivor-centric community reintegration.
Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area