The rehabilitation process after stroke - patients and relatives needs
There is a lack of evidence for how the post-acute stroke care and rehabilitation should best be organised and there is limited knowledge of patients' and relatives' needs of rehabilitation and support during the different phases of the rehabilitation process after stroke. Previous international studies have shown that close relatives perceive a high caregiver burden in activities of daily living. By increasing the patients' participation in rehabilitation, ability to solve problems in ADL and to transfer knowledge to new situations we expect that patients and relatives satisfaction in daily life will increase. In this new project patients' and their relatives' needs of rehabilitation and support in daily life during the first year after stroke is in focus.
Kerstin Tham, OT, PhD, Professor and Lena von Koch, PT, PhD, Professor.
Magnus Andersson, PhD, neurologist; Occupational therapists at the OT cllinic at the Karolinska University Hospital, Aileen Bergström, Lisa Ekstam, Gunilla Eriksson, Susanne Guidetti, Ulla Johansson, Malin Tistad and Charlotte Ytterberg.
1) To identify patients' and relatives' needs of rehabilitation and support during the first year after stroke,
2) To examine if there are gender differences,
3) To identify possible consequences of shorter periods of in-patient care at stroke units,
4) To, in a pilot study, evaluate the effect of a new client-centred intervention aiming to increase the patients' independence in ADL and decreasing the relatives' perception of caregiver burden in daily life after stroke.
This study is a population-based prospective longitudinal observational study. All patients at one of the three stroke units at the university hospital and their close relatives are examined at one week, 3, 6, 12 months post-stroke. Standardised assessment instruments and interview questions are used to collect data.
Long term goal:
The project will give new knowledge of patients' and relatives' needs of rehabilitation and support. The results will be used as the basis for the development of a new client-centred model for rehabilitation after initial care at a stroke unit.
Financial support was provided through the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet (ALF), Hjärnfonden (Swedish Brain Foundation) the Swedish Research Council, funds at Karolinska Institutet, the Postgraduate school in health care and the Swedish Stroke Association.
Doctoral theses that in whole or in part address research questions based on this project:
Susanne Guidetti 2008
Recapturing self-care after stroke or spinal cord injury: Exploration of experiences and evaluation of a client-centred intervention
Susanne Palmcrantz 2012
Long-term effects of stroke seen in young individuals living in the community
Malin Tistad 2012
Needs for, use of and satisfaction with health care services in the course of the first year after stroke: the perspective of people with stroke
Aileen Bergström 2012
Participation in everyday occupations and life satisfaction in the stroke-caregiver dyad
Publications in the project:
Aasnes M. Occupational gaps within a group of persons one year after stroke. KI, 2008.
Eriksson C. Occupational therapists reflections during developing and implementing a self-care intervention: expectation, anchoring and skepticism. KI, 2008.
Nilsson A. Foreign-born stroke patients in Stockholm: an investigation. KI, 2011.
Sjölander M. Length of hospital stay, motor function and walking ability after stroke - a comparison between 2006-2007 and 1993-1995. KI, 2008.
Steen-Åberg K. Caregiver burden after stroke: a comparison with respect to stroke severity and type of rehabilitation. KI, 2011.