Exploring Barriers and Facilitators to Early Rehabilitation in Post-Stroke Hand Dysfunction: A Qualitative Study

探讨卒中后手功能障碍早期康复的障碍和促进因素:一项定性研究

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Abstract

BACKGROUND: Early rehabilitation can improve limb function and enhance quality of life for patients with hand dysfunction following a stroke. Currently, there is a lack of research exploring the factors that facilitate or hinder the participation of patients with hand dysfunction in early rehabilitation. Exploring these factors is crucial for the formulation of strategies aimed at boosting patients' motivation towards early rehabilitation and cultivating their proactive engagement. AIM: This study aimed to explore the barriers and facilitators to early rehabilitation in post-stroke hand dysfunction. METHODS: This is a descriptive qualitative study. 15 patients with post-stroke hand dysfunction were selected using the purposive sampling method. Data were collected through semi-structured, face-to-face, in-depth interviews conducted at a tertiary hospital in Shanghai, China, between March and April 2024. The data were coded using NVivo software and analyzed via Braun and Clarke's reflective thematic approach. RESULTS: Four themes were identified, encompassing eight sub-themes: (1) gaining benefits from early treatments, (2) active participation of individuals and their families, (3) a low level of perceived self-efficacy, and (4) unmet medical needs. CONCLUSION: The likelihood of patients with hand dysfunction following a stroke participating in early rehabilitation treatments is influenced by numerous factors. Intervention strategies can be tailored around these factors and may include educating patients and their families about stroke and early rehabilitation, training healthcare professionals (HCPs) to enhance their skills, providing professional support to patients after discharge and optimizing health insurance policies.

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