RESUMEN
PURPOSE: Stroke is often regarded as a disease of the elderly. However, 10-15% of strokes occur in people aged 18 to 50, and rates continue to rise. Young stroke survivors face unique challenges due to their occupational, family and personal commitments, which current stroke rehabilitation services may not fully address. Our qualitative study aimed to identify gaps in patient care and resources for young stroke survivors. We used these findings to develop recommendations to inform clinical care, healthcare system design, and health policy. METHODS: Using Interpretive Description, we conducted semi-structured interviews with 19 stroke survivors aged 18-55 living in British Columbia, Canada, to explore their experiences during stroke recovery and assess current gaps in support and resources. We applied broad-based coding and thematic analysis to the transcripts. RESULTS: Key themes included: (1) the need for longitudinal medical follow-up and information provision, (2) the need for psychological/psychiatric care, (3) the need to adapt community supports and resources to young survivors, and (4) the need to centralize and integrate community stroke services and resources. CONCLUSION: Young stroke survivors experience unique challenges and lack appropriate services and resources. Many of our findings may be representative of remediable gaps that persist nationally and internationally.
Young Adult Stroke Survivors face unique challenges due to their occupational, family, and personal commitments, resulting in unmet needs during stroke recovery and rehabilitation.Policymakers, healthcare providers and community organizations need to re-think follow-up and information provision, psychological/psychiatric care, and community support and resources for young adult stroke survivors.Centralization and integration of different community stroke services and resources specific to young stroke survivors are key in stroke rehabilitation and recovery pathways.
RESUMEN
PURPOSE: Rural-dwelling stroke survivors have unmet rehabilitation needs after returning to community-living. Virtual rehabilitation, defined as the use of technology to provide rehabilitation services from a distance, could be a viable and timely solution to address this need, especially within the COVID-19 pandemic context. There is still a minimal understanding of virtual rehabilitation delivery within rural contexts. This study sought to explore the perceptions of rural stakeholders about virtual stroke rehabilitation. METHODS: Following an interpretive description approach, 17 qualitative interviews were conducted with stroke survivors (n = 5), caregivers (n = 2), clinicians (n = 7), and health administrators (n = 3), and analyzed to understand their experiences and perceptions of virtual stroke rehabilitation. RESULTS: We identified three overarching themes from the participant responses (1) The Root of the (Rural) Problem considered how systemic inequities impact stroke survivors' and caregivers' access to stroke recovery services; (2) Common Benefits, Different Challenges identified the unique benefits and challenges of delivering virtual rehabilitation within rural contexts; and (3) Ingredients for Success described important considerations for implementing virtual rehabilitation. CONCLUSION: Virtual rehabilitation is generally accepted by all stakeholders as a supplement to in-person services. Addressing the unique barriers faced by rural clinicians and stroke survivors is necessary to provide successful virtual rehabilitation.
Understanding the perceptions of virtual rehabilitation from various stakeholders may contribute to more effective provision of stroke services.Understanding unique rural practice challenges faced by clinicians may inform future protocols for virtual rehabilitation.The need for additional support for clinicians and stroke survivors is a determining factor for successful virtual rehabilitation.Incorporating virtual rehabilitation as an adjunct to face-to-face services is accepted by all stakeholders.