Factors related to met needs for rehabilitation 6 years after stroke

Abstract

Introduction Research on stroke rehabilitation mainly concerns the first year of recovery, and there is a lack of knowledge regarding long-term rehabilitation needs and associated factors. Aim The aim was to explore the perceived needs for rehabilitation services of people six years after stroke and factors associated with having rehabilitation services needs met. Methods The study was a 6-year follow up of a prospective study on the rehabilitation process after stroke. Data on perceived needs for rehabilitation, personal factors, disease specific factors, and patient-reported disability were collected through face-to-face interviews in the participants' homes. Logistic regression models were created to explore associations between having rehabilitation services needs met in 11 problem areas (dependent variable) and the independent variables: involvement in decisions regarding care and treatment, sex, age, sense of coherence, self-defined level of private financing, stroke severity, frequency of social everyday activities, perceived impact of stroke, and life satisfaction. Results The 121 participants had a mean age of 63 years at stroke onset and 58% were men. In all problem areas the majority (53-88%) reported having needs met at six years after stroke, however 47% reported unmet needs regarding fatigue and 45% regarding mobility. A lower perceived impact on participation was found to be associated with having rehabilitation services needs met in seven problem areas: mobility, falls, pain, fatigue, concentration, memory, and sight. The strongest association for having needs met was found for the independent variable, involvement in care and treatment, within the three problem areas mobility, falls, and speaking.

Spasticity, Pain, and Fatigue

“…Our findings suggest that fatigue is the most prominent symptom that interferes with many physical functions, including ADLs and mobility, which is not surprising. The results of this study support the findings of Ytterberg et al (2020), who found that patients with stroke continue to feel fatigue long after their brain injury, which continues to impede their mobility. Curiously, we noted that, on admission, our participants were very optimistic about their ability to perform tasks and daily functions; however, their confidence tempered as they spent time in physical, occupational, and speech therapies.…”

Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives

“…A further need expressed was the appreciation of the importance of any programme being flexible to meet the needs of those with fluctuating energy levels. Many clinicians felt that programmes should address long-term needs of people, a perception in line with the findings of research with longer follow up of people with PSF, which suggests fatigue is a factor for many survivors for many years after their stroke (Duncan et al, 2020;Ytterberg et al, 2020). There was a strong belief across the professional groups that people needed support to self-manage their fatigue.…”

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

“…Participants portrayed the importance of inclusive communication between stroke survivors and the HCPs treating them, where stroke survivors feel their individual needs are considered. This has been reflected elsewhere, as stroke survivors who report a perceived involvement in their care and treatment are associated with reporting their recovery service needs being met ( 87 ). More specifically, met needs have also been associated with shared decision-making in the rehabilitation goal-setting process ( 88 , 89 ).…”