University of Nottingham, Nottingham, UK.
University of Leicester, Leicester, UK.
Disabil Rehabil. 2023 Aug;45(16):2604-2611. doi: 10.1080/09638288.2022.2102251. Epub 2022 Jul 27.
To explore how stroke survivors' expectations and understanding of Early Supported Discharge (ESD) helped them make sense of their experiences, and shaped their engagement with the service.
Data were collected as part of a study of large-scale implementation of stroke ESD: the WISE realist mixed-methods study. Semi-structured interviews were conducted with five purposefully selected stroke survivors from six sites in England implementing stroke ESD ( = 30). Participants were aged 32-88 years (20 males). Interviews were audio recorded, transcribed verbatim and transcripts were analysed using reflexive thematic analysis.
Three overarching themes were identified: (1) ESD as a post-stroke recovery tool, (2) desire to recover quickly, (3) psychosocial impact and support. Stroke survivors were uncertain about what to expect when they first entered the service, however, their experience of ESD exceeded their expectations and increased their engagement with the service. Stroke survivors especially valued the goal-oriented approach the team adopted. Rehabilitation at home was perceived as positive and practical, encouraging independence within real-life contexts. Psycho-social support played an important role in the stroke survivors' rehabilitation.
Ensuring stroke survivors are fully informed about ESD and what to expect, optimises engagement with the services, improves experience and could enhance outcomes.IMPLICATIONS FOR REHABILITATIONInforming stroke survivors about what to expect from ESD services could optimise engagement and improve their experience.The provision of personalised and target focussed therapy at home improves stroke survivors' experience and could potentially accelerate recovery.Preparing stroke survivors early for discharge from ESD can reduce anxiety and enhance engagement with the service.
探讨中风幸存者对早期支持出院（ESD）的期望和理解如何帮助他们理解自己的经历，并影响他们对服务的参与。
数据是作为中风 ESD 大规模实施研究的一部分收集的：WISE 真实主义混合方法研究。从在英格兰实施中风 ESD 的六个地点中，有针对性地选择了五名中风幸存者进行半结构式访谈（ = 30）。参与者年龄在 32-88 岁之间（男性 20 人）。对访谈进行了录音、逐字记录，并使用反思性主题分析对转录本进行了分析。
确定了三个总体主题：（1）ESD 作为中风后康复工具，（2）快速康复的愿望，（3）心理社会影响和支持。中风幸存者在最初进入服务时对期望不确定，但他们对 ESD 的体验超出了预期，并增加了对服务的参与度。中风幸存者特别重视团队采用的目标导向方法。家庭康复被认为是积极和实用的，在现实生活环境中鼓励独立。心理社会支持在中风幸存者的康复中发挥了重要作用。
确保中风幸存者充分了解 ESD 及其期望，可以优化对服务的参与度，改善体验，并可能改善结果。
告知中风幸存者有关 ESD 服务的期望，可以优化参与度并改善他们的体验。在家庭中提供个性化和以目标为重点的治疗可以改善中风幸存者的体验，并有可能加速康复。提前让中风幸存者为 ESD 出院做好准备，可以减轻焦虑并提高对服务的参与度。
