Patients' experiences of very early supported discharge after stroke: safety, emotional support and feelings of control in everyday life

Karin Törnbom; Gunnel E Carlsson; Åsa Nordin; Katharina S Sunnerhagen

doi:10.1080/09638288.2024.2415332

Patients' experiences of very early supported discharge after stroke: safety, emotional support and feelings of control in everyday life

Disabil Rehabil. 2024 Oct 20:1-8. doi: 10.1080/09638288.2024.2415332. Online ahead of print.

Authors

Karin Törnbom^{1

2

3}, Gunnel E Carlsson¹, Åsa Nordin¹, Katharina S Sunnerhagen^{1

4}

Affiliations

¹ Institute of Neuroscience and Physiology, Department of Clinical Neuroscience/Rehabilitation Medicine, Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden.
² Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
³ Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden.

PMID: 39427246
DOI: 10.1080/09638288.2024.2415332

Abstract

Objective: Early supported discharge (ESD) aims to enable the transition of care from specialised stroke units to patients' homes. Even though ESD is well-researched, little is known about the experiences faced by persons with stroke in very early supported discharge (VESD). The aim of this study was to understand these experiences when participating in a VESD rehabilitation program.

Methods: Qualitative individual and semi-structured interviews were held (at 3 months post-discharge) with stroke survivors discharged home at a very early stage and participating in a VESD programme. A thematic analysis process was applied.

Results: Nine participants living in Sweden and following a mild or moderate stroke expressed their narratives through the following themes: "The importance of the VESD team intervention during the initial home rehabilitation"; "Everyday life was perceived as a struggle depending on close relatives"; "Experiencing problems with fatigue and low energy" and "Feeling angrier or more worried in everyday life".

Conclusions: Home-based VESD rehabilitation was important for increasing patients' sense of independence and control in daily life, while at the same time making them feel secure in the support from the rehabilitation team. Future research may investigate how VESD functions in other countries and healthcare systems.

Keywords: Stroke; early supported discharge; home rehabilitation; lived experiences; multi-professional team; qualitative interviews.

Plain language summary

People following a stroke seem positive to rehabilitate in their familiar home environment when working towards personalised goals with the support of a rehabilitation team.Through Very Early Supported Discharge people with stroke may experience engagement and motivation in their own rehabilitation process from the onset.Very Early Supported Discharge tends to encourage family members to be supportive and involved in the rehabilitation early after a stroke.Early rehabilitation in a home environment may enhance the individuals’ feelings of self-reliance and independence.