Faculty of Health Sciences, University of Sydney , Sydney , Australia.
Health and Social Sciences Cluster, Singapore Institute of Technology , Singapore.
Disabil Rehabil. 2019 Oct;41(21):2528-2537. doi: 10.1080/09638288.2018.1471168. Epub 2018 May 18.
This study investigates the perspectives of rehabilitation therapists on the implementation of fall prevention programmes with community-dwelling stroke survivors in the Singapore context, and elicits recommendations to adapt the Stepping On programme with stroke survivors. Qualitative data were elicited during 4 focus groups with 23 rehabilitation therapists (15 occupational therapists [OTs]; 8 physiotherapists [PTs]) who had received training to deliver the original Stepping On programme, and had experienced delivery of fall-prevention intervention programmes locally. Collected data were analysed using thematic analysis method. Three themes emerged from the focus groups describing: (a) limitations of existing falls prevention intervention for stroke clients; (b) the need to adapt the Stepping On programme to use with stroke clients; and (c) challenges in implementing fall prevention programmes in the stroke context. A series of new components were suggested to be included as part of the Stepping On after stroke (SOAS) programme, including involvement of family members and caregivers, and tailored community reintegration sessions (such as taking public transport and shopping). Rehabilitation therapists describe challenges in addressing fall prevention within a stroke context, and findings highlight the need for a structured, stroke-specific fall prevention programme rather than a more general approach to education and training. Contextual components identified provide valuable inputs towards the development of a culturally relevant fall prevention programme for stroke survivors in Singapore. Implications for Rehabilitation Stroke survivors living in the community are at a high risk of falls. A structured and culturally relevant fall prevention programme for community-living stroke survivors is needed. Falls prevention for community-living stroke survivors should be multi-dimensional and targeting the modifiable risk factors for falls in this group. Both stroke survivors and caregivers should be involved in any fall prevention after stroke programmes.
本研究调查了康复治疗师在新加坡背景下为社区居住的中风幸存者实施防跌倒计划的观点，并提出了调整 Stepping On 计划以适应中风幸存者的建议。在 4 个焦点小组中收集了定性数据，共有 23 名康复治疗师（15 名职业治疗师[OT]；8 名物理治疗师[PT]）参加了焦点小组，他们接受过提供原始 Stepping On 计划的培训，并在当地开展过防跌倒干预计划。使用主题分析方法对收集的数据进行分析。焦点小组提出了三个主题，描述了：（a）现有的防跌倒干预措施对中风患者的局限性；（b）需要调整 Stepping On 计划以用于中风患者；（c）在中风背景下实施防跌倒计划的挑战。建议在 Stepping On 后（SOAS）计划中增加一系列新的组成部分，包括家庭成员和照顾者的参与，以及量身定制的社区重新融入课程（如乘坐公共交通工具和购物）。康复治疗师描述了在中风环境中解决防跌倒问题的挑战，研究结果强调需要一个结构化的、针对中风的防跌倒计划，而不是更一般的教育和培训方法。确定的环境组成部分为开发新加坡中风幸存者的文化相关防跌倒计划提供了有价值的投入。对康复的影响 居住在社区中的中风幸存者跌倒的风险很高。需要为社区居住的中风幸存者制定结构化的、文化相关的防跌倒计划。社区居住的中风幸存者的防跌倒应是多维度的，针对该人群中可改变的跌倒风险因素。任何防跌倒后中风计划都应包括中风幸存者和照顾者。
