Disability and Rehabilitation · 2009 · 137 citations · 25 references
MedicineRehabilitation MedicineNeurorehabilitationRehabilitationStroke RehabilitationNeurological RehabilitationPhysical RehabilitationPsychosocial Aspects Of DisabilityPsychosocial RehabilitationRehabilitation PsychologyReturn-to-activity RehabilitationActivities-based RehabilitationEnvironmental FactorsLongitudinal Case StudyMotor Recovery After StrokePost-stroke RecoveryPost-stroke RehabilitationSemi-structured InterviewsStroke Disability
PURPOSE: In this article, we aim to develop the understanding of what helps or hinders resumption of valued activities up to 12-months post-stroke. METHOD: As part of a longitudinal study, semi-structured interviews were conducted with 19 people with stroke and eight informal carers 12-months post-stroke. Interviews covered ongoing effects of stroke, experience of trying to resume activities highlighted as important pre-stroke and factors that influenced progress. Interviews were transcribed, coded and analysed in depth to explore this aspect of the experience of living with stroke. RESULTS: Valued activities discussed related to employment; domestic and social roles including driving; hobbies, sports and socialising. Outcomes for individuals were influenced by: aspects of physical or cognitive disability; environmental factors; the adaptability of the individual; support from others and professional help. Inability to resume activities impacted on people's sense of self and quality of life, but some tolerated change and presented themselves as adaptable. CONCLUSIONS: This study indicates a long-term role for rehabilitation services such as: identifying the significance of different types of activities; providing access to support and treatment for debilitating symptoms such as fatigue and dizziness; addressing patients' emotional and behavioural responses to their condition; working with patients' wider social networks and where appropriate, supporting adaptation to a changed way of life.
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