How do stroke survivors experience rehabilitation goal setting and plans to support their rehabilitation? A qualitative study.

Abstract

Patient involvement and goal setting are essential components of stroke rehabilitation. However, ensuring continuity and patient engagement can be challenging due to different settings and time points throughout rehabilitation journey. This study aimed to explore stroke survivors' experiences with their rehabilitation plan across hospital-to-municipality transition. This qualitative study involved individual interviews with stroke survivors who received standard rehabilitation plans for municipal rehabilitation after hospital discharge. Participants shared their reflections on their cross-sectoral rehabilitation experience. Data were analyzed using reflexive thematic analysis outlined by Braun and Clarke. We interviewed 17 participants from eight municipalities within the hospital's service area. Analysis identified two main themes: Misalignment of rehabilitation goals and plans with patient needs and Navigating Inequity in Rehabilitation: Unmet Needs and Personal Strategies. Four subthemes included Challenges in Defining Goals, Lack of Patient Involvement in Goal Setting, Seeking Supplementary Care to Meet Unmet Needs, and Living Within and Beyond a Standardized System. Rehabilitation goals are not always clearly communicated to stroke survivors, and insufficient patient-centered approaches suggest potential gaps in the rehabilitation system. Additionally, timing of rehabilitation plans often does not align with patients' needs, indicating a need for more adaptable and responsive rehabilitation pathways.