Factors Affecting Functional Improvement in the Initial Months of Recovery After Stroke: A Pilot Study.

Abstract

Abstract: BACKGROUND: The purpose of this study is to examine factors affecting functional improvement among survivors of stroke during the initial months of stroke recovery. METHODS: A 1-group repeated measures sequential mixed methods design was used. Quantitative longitudinal data were collected on admission, discharge, and postdischarge from the inpatient rehabilitation unit to evaluate the change in patient engagement and the relationship between environmental, personal, and behavioral factors, and functional independence. Semistructured interviews were conducted up to 6 months postdischarge. RESULTS: The sample included 27 participants with a mean age of 64.67 (SD = 13.56). There was a significant increase in patient engagement from admission to discharge (P < .0001), followed by a nonsignificant decrease from discharge to follow-up (P = .36). The change in functional improvement from admission to discharge was significant (P < .0001). Stroke severity was the only significant predictor of functional improvement (P = .008). There was a significant but weak negative correlation between Patient Health Engagement scale (PHE-s®) total score and sleep disturbance (r = -0.344, P = .008) and sleep disturbance and self-efficacy (r = -0.362, P = .005). There was a moderate positive correlation between PHE-s total score and self-efficacy (r = 0.662, P < .001). Five participants participated in follow-up interviews. The 5 main themes that emerged from interview data were (1) feeling happy to be home, (2) wishing recovery was quicker, (3) living with disability, (4) overcoming obstacles, and (5) social support. CONCLUSION: This pilot study provides insight into the experiences of survivors of stroke during rehabilitation and recovery. The results of this study indicate a need for additional support (eg, transportation, social/emotional) for survivors of stroke after discharge from the rehabilitation unit. Further research to investigate the barriers and facilitators of recovery for survivors of stroke after discharge and the development of interventions aimed at improving sustainable recovery outcomes is needed.