Dalarna University's logo and link to the university's website

du.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The importance of context-a qualitative study exploring healthcare practitioners' experiences of working with patients at home after a stroke
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0001-7044-8896
Lund University.ORCID iD: 0000-0002-0068-943X
Lund University; Health and Social Care Administration, Östersund; Umeå University.ORCID iD: 0000-0002-1087-8656
Dalarna University, School of Health and Welfare, Caring Science/Nursing. Lund University.ORCID iD: 0000-0003-2887-3674
2023 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 733Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Stroke significantly impacts individuals, leading to the need for long-lasting rehabilitation and adaptation to environmental demands. Rehabilitation after stroke is increasingly performed in patients' homes, and it is argued that rehabilitation in this context is more person-centred and positively impacts client outcomes. However, the role of environmental factors in this process is largely unknown. The aim of this study was to explore how multidisciplinary healthcare practitioners working with rehabilitation in the home after stroke consider possibilities and challenges in the environment and how environmental factors are documented in patients' records.

METHODS: Eight multidisciplinary healthcare practitioners working with home-based rehabilitation after stroke participated in two semistructured focus group sessions. Thematic analysis was used to analyse the transcripts of recorded focus group discussions. Data were also collected from patient history records (N = 14) to identify interventions to increase patients' opportunities to participate in activities inside and outside the home. These records were analysed using life-space mobility as a conceptual framework.

RESULTS: The analysis generated four overarching themes concerning possibilities and challenges in the environment: (1) the image of rehabilitation conflicts with place, (2) the person in the home reveals individual needs and capabilities, (3) environmental characteristics influence the rehabilitation practice, and (4) the person is integrated within a social context. The patient record analysis showed that most patients were discharged from hospital to home within four days. Assessments at the hospital mainly focused on basic activities of daily living, such as the patient's self-care and walking ability. Also at home, the assessments and actions primarily focused on basic activities with little focus on participation in meaningful activities performed in different life situations outside the home.

CONCLUSIONS: Our research suggests that one way to improve practice is to include the environment in the rehabilitation and consider the person´s life space. Interventions should focus on supporting out-of-home mobility and activities as part of person-centred stroke rehabilitation. This must be supported by clear documentation in the patient records to strengthen clinical practice as well as the communication between stakeholders.

Place, publisher, year, edition, pages
2023. Vol. 23, no 1, article id 733
Keywords [en]
Built environment, ESD, Life-space, Person-centred care, Person-environment fit, Rehabilitation
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:du-46428DOI: 10.1186/s12913-023-09735-7ISI: 001024933200001PubMedID: 37415156Scopus ID: 2-s2.0-85164261156OAI: oai:DiVA.org:du-46428DiVA, id: diva2:1781761
Available from: 2023-07-11 Created: 2023-07-11 Last updated: 2023-08-07Bibliographically approved

Open Access in DiVA

fulltext(1274 kB)57 downloads
File information
File name FULLTEXT01.pdfFile size 1274 kBChecksum SHA-512
033d862a8c2de5437c5b6c0d564d8831ca8e9f2c6bd9297c2d73dbad5f13e9a5c611c5f566fda49e2609676412e2a184f4c7b711c7d11509125239712c1229e8
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Elf, MarieKylén, Maya

Search in DiVA

By author/editor
Elf, MarieRasoal, DaraZingmark, MagnusKylén, Maya
By organisation
Caring Science/Nursing
In the same journal
BMC Health Services Research
Occupational Therapy

Search outside of DiVA

GoogleGoogle Scholar
Total: 57 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 69 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf