Qin Xiaohuan, Zou Qinhan, He Yanan, Liu Lang, Zhao Chunyan
School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.
Nursing Department, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People's Republic of China.
J Multidiscip Healthc. 2025 Jul 31;18:4469-4480. doi: 10.2147/JMDH.S533560. eCollection 2025.
Early rehabilitation can improve limb function and enhance quality of life for patients with hand dysfunction following a stroke. Currently, there is a lack of research exploring the factors that facilitate or hinder the participation of patients with hand dysfunction in early rehabilitation. Exploring these factors is crucial for the formulation of strategies aimed at boosting patients' motivation towards early rehabilitation and cultivating their proactive engagement.
This study aimed to explore the barriers and facilitators to early rehabilitation in post-stroke hand dysfunction.
This is a descriptive qualitative study. 15 patients with post-stroke hand dysfunction were selected using the purposive sampling method. Data were collected through semi-structured, face-to-face, in-depth interviews conducted at a tertiary hospital in Shanghai, China, between March and April 2024. The data were coded using NVivo software and analyzed via Braun and Clarke's reflective thematic approach.
Four themes were identified, encompassing eight sub-themes: (1) gaining benefits from early treatments, (2) active participation of individuals and their families, (3) a low level of perceived self-efficacy, and (4) unmet medical needs.
The likelihood of patients with hand dysfunction following a stroke participating in early rehabilitation treatments is influenced by numerous factors. Intervention strategies can be tailored around these factors and may include educating patients and their families about stroke and early rehabilitation, training healthcare professionals (HCPs) to enhance their skills, providing professional support to patients after discharge and optimizing health insurance policies.
早期康复可改善脑卒中后手功能障碍患者的肢体功能，提高其生活质量。目前，缺乏对促进或阻碍手功能障碍患者参与早期康复的因素的研究。探索这些因素对于制定旨在增强患者早期康复动力并培养其积极参与的策略至关重要。
本研究旨在探讨脑卒中后手功能障碍患者早期康复的障碍和促进因素。
这是一项描述性定性研究。采用目的抽样法选取15例脑卒中后手功能障碍患者。于2024年3月至4月在中国上海的一家三级医院，通过半结构化、面对面、深入访谈收集数据。使用NVivo软件对数据进行编码，并通过布劳恩和克拉克的反思性主题分析法进行分析。
确定了四个主题，包含八个子主题：（1）从早期治疗中获益；（2）个人及其家庭的积极参与；（3）自我效能感水平较低；（4）未满足的医疗需求。
脑卒中后手功能障碍患者参与早期康复治疗的可能性受多种因素影响。可围绕这些因素制定干预策略，可能包括对患者及其家属进行脑卒中及早期康复教育、培训医护人员以提高其技能、出院后为患者提供专业支持以及优化医疗保险政策。
