Fu Vivian, Thompson Stephanie, Kayes Nicola, Bright Felicity
Calgary Stroke Program, Dept of Clinical Neurosciences, University of Calgary, Calgary, Canada.
Medical Research Institute of New Zealand, Aotearoa, Wellington, New Zealand.
Curr Neurol Neurosci Rep. 2025 Feb 3;25(1):17. doi: 10.1007/s11910-025-01403-z.
Rehabilitation is the mainstay of recovery after stroke, but key recommendations focused on delivering 'as much therapy as possible' and stroke survivor outcome measures have remained relatively unchanged for decades. Traditional therapy approaches focus on maximum improvement of physical impairments while a stroke survivor is in hospital to ensure that community discharge can be deemed 'safe'. This narrow approach sidelines the outcomes that are meaningful to the stroke survivor in the long term and the challenges they may face within their social context. In this article, we highlight the importance of the whole-person approach and review recent research introducing novel considerations to optimise outcomes after stroke.
Psychosocial well-being is a major component of health but is poorly acknowledged and managed for stroke survivors. Evidence supports the use of self-management interventions, peer befriending, and culturally - responsive methods, including deep engagement with Indigenous and cultural knowledge. Cultural safety and involvement of a stroke survivor's important personal connections are also vital for achieving truly person-centred care and equity in rehabilitation outcomes. Outcomes in rehabilitation will be optimised if we shift our mindsets from a sole focus on improving physical impairments to a broader scope of delivering whole-person care.
康复是卒中后恢复的主要手段,但几十年来,重点建议一直聚焦于提供“尽可能多的治疗”,且卒中幸存者的结局衡量指标相对没有变化。传统治疗方法侧重于在卒中幸存者住院期间最大程度改善身体损伤,以确保出院至社区时可被视为“安全”。这种狭隘的方法忽视了对卒中幸存者长期有意义的结局以及他们在社会环境中可能面临的挑战。在本文中,我们强调全人方法的重要性,并回顾近期研究,这些研究引入了新的考量因素以优化卒中后的结局。
心理社会幸福感是健康的重要组成部分,但对于卒中幸存者而言,其得到的认知和管理却很不足。有证据支持采用自我管理干预、同伴交友以及具有文化响应性的方法,包括深入参与原住民和文化知识。文化安全以及卒中幸存者重要个人关系的参与对于实现真正以患者为中心的护理和康复结局公平性也至关重要。如果我们将思维模式从单纯关注改善身体损伤转变为提供更广泛的全人护理,康复结局将得到优化。