Stroke survivors' perspectives on decisions about their transition to independent walking in hospital: a qualitative study.

Abstract

To explore perspectives of stroke survivors on their transition to independent walking in hospital. Specifically, this included the lived experience of lost walking independence, the decision-making process, and perspectives on risk. Qualitative design with phenomenological approach. Thirty semi-structured interviews were conducted with 22 stroke survivors at two inpatient stroke units. Interviews were recorded and transcribed verbatim with reflexive thematic analysis conducted. Three themes with four subthemes were developed from the data: (1) Rehabilitation is a roller coaster (subthemes: mixed emotions in rehabilitation; learning the ropes takes time); (2) I am not an expert (subthemes: trust in the physiotherapist's decision; walking alone against advice); and (3) Variable approach to risk. Loss of independent walking contributed to feelings of disempowerment; aligned most frequently with loss of independent toileting. Participants believed health professionals made walking safety decisions on their behalf and were mostly satisfied with this process. Participants varied in their awareness of personal safety strategies, with some having limited awareness of specific factors that could contribute to falls. Study findings highlight challenges for stroke survivors and their participation in decision-making related to independent walking in hospital. These findings have the potential to inform future practice guidelines.