Institute of Neuroscience and Physiology, Department of Clinical Neuroscience/Rehabilitation Medicine, Sahlgrenska Academy University of Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience/Rehabilitation Medicine, Sahlgrenska Academy University of Gothenburg, Sweden; Faculty of Social Sciences, Department of Social Work, University of Gothenburg, Sweden.
J Stroke Cerebrovasc Dis. 2024 Sep;33(9):107869. doi: 10.1016/j.jstrokecerebrovasdis.2024.107869. Epub 2024 Jul 18.
To explore patients' experiences of coming home and managing everyday life within the context of very early supported discharge after stroke (VESD).
An explorative qualitative study using semi structured interviews.
This study was nested within a randomised controlled trial,; Gothenburg Very Early Supported Discharge (GOTVED), comparing a home rehabilitation intervention given by a coordinated team (VESD) with conventional care. Eleven participants with a median age 70.0 years (range 63-95) of which nine scoring 0-4 on the NIHSS indicating no symptoms or minor stroke were interviewed on average 12 days after discharge. Data was analysed using thematic analysis.
The diversity of patients' experiences was reflected in the overarching main theme Very Early Supported Discharge after stroke - a multifaceted experience, built upon five themes: "Conditions surrounding the discharge", "Concerns about the condition", "Confronting a new everyday life", "Experiences of the intervention" and the "Role of next of kin".
The respondents were largely satisfied with the very early supported discharge which might be expected, given that it was well planned regarding timing, individualisation and content. The patients need to be aware of the purpose of the VESD intervention. Due to the unpredictability of the stroke and its consequences, interventions need to be flexible. Goal setting is important but must be comprehensible. The role and burden of next of kin should be addressed and negotiated, and the ending of the intervention must be planned, with seamless transition to further rehabilitation and social support including the issue of participation in everyday life.
在极早期支持性出院（VESD）背景下探索患者在中风后回家和管理日常生活的体验。
采用半结构化访谈的探索性定性研究。
本研究嵌套在一项随机对照试验中，即哥德堡极早期支持性出院（GOTVED），比较了由协调团队提供的家庭康复干预（VESD）与常规护理。11 名参与者的中位年龄为 70.0 岁（范围为 63-95 岁），其中 9 名 NIHSS 评分为 0-4，表明无症状或轻度中风，出院后平均 12 天进行访谈。使用主题分析对数据进行分析。
患者体验的多样性反映在总体主题极早期支持性中风出院 - 多方面的体验，建立在五个主题之上：“出院周围的条件”、“对病情的担忧”、“面对新的日常生活”、“干预体验”和“亲属的角色”。
受访者对极早期支持性出院基本满意，这可能是预期的，因为它在时间、个性化和内容方面都有很好的计划。患者需要了解 VESD 干预的目的。由于中风及其后果的不可预测性，干预措施需要具有灵活性。目标设定很重要，但必须易于理解。应解决和协商亲属的角色和负担问题，并计划干预的结束，与进一步的康复和社会支持无缝过渡，包括参与日常生活的问题。
