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Barriers and facilitators for stroke patients' adherence to rehabilitation in China: a qualitative study based on medical experts.

作者信息

Liu Meng, Wu Ziting, Liu Gordon G, Xiao Luyang, Li Shanshan

机构信息

Institute for Global Health and Development, Peking University, Beijing, China.

National School of Development, Peking University, Beijing, China.

出版信息

Sci Rep. 2025 Aug 27;15(1):31525. doi: 10.1038/s41598-025-12795-w.


DOI:10.1038/s41598-025-12795-w
PMID:40866421
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12391386/
Abstract

Stroke is a neurological condition characterized by prolonged rehabilitation, requiring long-term patient cooperation for effective recovery. Rehabilitation adherence plays an important role in the prognosis. This study aimed to identify the patient-, doctor-, hospital-, and society-level factors influencing rehabilitation adherence. In this qualitative study, semi-structured interviews were conducted with 25 experts in rehabilitation medicine, cardiovascular medicine, and neurology from six representative cities in China (Beijing, Tianjin, Shanghai, Wuhan, Harbin, and Chengdu) to explore the factors affecting rehabilitation adherence. Transcripts were coded and analyzed using an inductive thematic approach for data analysis. NVivo 14 was used to manage and analyze the textual data. All methods were performed in accordance with relevant guidelines and regulations, specifically the Guidelines for the "Prevention and Treatment of Cerebrovascular Diseases (2024 Edition)" and the "2024 China Stroke Prevention and Treatment Guidelines" issued by the General Office of the National Health Commission of the People's Republic of China. Regarding in-hospital rehabilitation, medical experts believed that the characteristics of patients who had a stroke directly affected their rehabilitation adherence, including rehabilitation expectations, self-efficacy, economic pressure, family support, and trust in doctors. Additionally, medical experts also believed that various factors at the doctor, hospital, and societal levels influence patient characteristics, such as doctors' professional skills, collaboration between departments, and social cognition, ultimately affecting rehabilitation adherence. For out-of-hospital rehabilitation, medical experts believed that the key determinants of adherence include accessibility to tele-rehabilitation, tele-medical resources, and active participation of hospital outpatient clinics. Most medical experts believed that it is crucial to focus not only on direct factors, such as rehabilitation expectations and self-efficacy, which influence patients' subjective intentions, but also on identifying the pathways through which doctors, hospitals, and societal factors impact patient behavior. Attention should be given to in- and out-of-hospital rehabilitation.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/12391386/87fb70f283cc/41598_2025_12795_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/12391386/db890999f310/41598_2025_12795_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/12391386/87fb70f283cc/41598_2025_12795_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/12391386/db890999f310/41598_2025_12795_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/12391386/87fb70f283cc/41598_2025_12795_Fig2_HTML.jpg

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本文引用的文献

[1]
Development and validation of the Chinese patient-centered integrated care scale.

BMC Health Serv Res. 2024-12-31

[2]
Perceived social support, self-management, perceived stress, and post-traumatic growth in older patients following stroke: Chain mediation analysis.

Medicine (Baltimore). 2024-7-19

[3]
Experiences of health service access: A qualitative interview study of people living with Parkinson's disease in Ireland.

Health Expect. 2024-2

[4]
Food Insecurity and Perceived Financial Stress are Associated with Cost-related Medication Non-adherence in Stroke.

J Health Care Poor Underserved. 2023

[5]
Secondary Ischemic Stroke Prevention.

Neurotherapeutics. 2023-4

[6]
Interpersonal challenges in surgical care provision in rural Mexico: A qualitative study.

Lancet Reg Health Am. 2022-2-21

[7]
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J Clin Nurs. 2023-1

[8]
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Lancet Public Health. 2021-12

[9]
Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004-18.

Lancet. 2021-7-3

[10]
Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

Lancet. 2020-10-17

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