{"title":"探索中风后早期阶段上肢康复关注度低的原因:定性研究。","authors":"Chioma Obinuchi Wodu BTech, MSc , Gillian Sweeney PhD , Andrew Kerr PhD","doi":"10.1016/j.jht.2024.08.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>One aspect that is often impaired in people living with stroke is the motor function of the upper limb.</div></div><div><h3>Purpose</h3><div>To explore the reasons behind the low focus on upper limb rehabilitation after stroke and to understand the views of rehabilitation professionals (RPs) on the use of upper limb rehabilitation technologies for self-management of stroke.</div></div><div><h3>Study Design</h3><div>A qualitative descriptive design that employs a one-on-one semistructured interview method.</div></div><div><h3>Methods</h3><div>A total of nine RPs (physiotherapist <em>n</em> = 6 and occupational therapist <em>n</em> = 3) participated. Interviews were held in person or via teleconferencing, recorded, and transcribed verbatim. All transcribed data were analyzed using thematic analysis, with an inductive approach.</div></div><div><h3>Results</h3><div>The average length of practice years of the RPs in this study was 24.7 ± 9.8, with 16.44 ± 9.19 experience in neurological rehabilitation. The views gathered from all nine (9/9) RPs point to a low focus on upper limb rehabilitation for people living with stroke. In an inpatient setting, this was attributed to the rehabilitation goals/ priorities (of people living with stroke, RPs, and/or hospital’s rehabilitation/stroke units), inadequate resources, and the inability of the RPs to deal with the high incidence of stroke. After discharge, it was attributed to the cost of securing private rehabilitation and poor knowledge of technologies that can support self-rehabilitation. The cost, design, and inadequacy of evidence on the effectiveness of some available upper limb rehabilitation technologies were noted as reasons that could make it difficult for RPs to promote the use of rehabilitation technologies.</div></div><div><h3>Conclusions</h3><div>There is a low focus on upper limb rehabilitation after a stroke, particularly during the early stages, owing to the pursuit of early discharge which appears to attach higher priority to the lower limb in addition to inadequate resources and lack of capacity to deal with the high incidence of stroke.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 52-60"},"PeriodicalIF":2.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploring the reasons behind the low focus on upper limb rehabilitation in the early stages after a stroke: A qualitative study\",\"authors\":\"Chioma Obinuchi Wodu BTech, MSc , Gillian Sweeney PhD , Andrew Kerr PhD\",\"doi\":\"10.1016/j.jht.2024.08.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>One aspect that is often impaired in people living with stroke is the motor function of the upper limb.</div></div><div><h3>Purpose</h3><div>To explore the reasons behind the low focus on upper limb rehabilitation after stroke and to understand the views of rehabilitation professionals (RPs) on the use of upper limb rehabilitation technologies for self-management of stroke.</div></div><div><h3>Study Design</h3><div>A qualitative descriptive design that employs a one-on-one semistructured interview method.</div></div><div><h3>Methods</h3><div>A total of nine RPs (physiotherapist <em>n</em> = 6 and occupational therapist <em>n</em> = 3) participated. Interviews were held in person or via teleconferencing, recorded, and transcribed verbatim. All transcribed data were analyzed using thematic analysis, with an inductive approach.</div></div><div><h3>Results</h3><div>The average length of practice years of the RPs in this study was 24.7 ± 9.8, with 16.44 ± 9.19 experience in neurological rehabilitation. The views gathered from all nine (9/9) RPs point to a low focus on upper limb rehabilitation for people living with stroke. In an inpatient setting, this was attributed to the rehabilitation goals/ priorities (of people living with stroke, RPs, and/or hospital’s rehabilitation/stroke units), inadequate resources, and the inability of the RPs to deal with the high incidence of stroke. After discharge, it was attributed to the cost of securing private rehabilitation and poor knowledge of technologies that can support self-rehabilitation. The cost, design, and inadequacy of evidence on the effectiveness of some available upper limb rehabilitation technologies were noted as reasons that could make it difficult for RPs to promote the use of rehabilitation technologies.</div></div><div><h3>Conclusions</h3><div>There is a low focus on upper limb rehabilitation after a stroke, particularly during the early stages, owing to the pursuit of early discharge which appears to attach higher priority to the lower limb in addition to inadequate resources and lack of capacity to deal with the high incidence of stroke.</div></div>\",\"PeriodicalId\":54814,\"journal\":{\"name\":\"Journal of Hand Therapy\",\"volume\":\"38 1\",\"pages\":\"Pages 52-60\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0894113024000644\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0894113024000644","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Exploring the reasons behind the low focus on upper limb rehabilitation in the early stages after a stroke: A qualitative study
Background
One aspect that is often impaired in people living with stroke is the motor function of the upper limb.
Purpose
To explore the reasons behind the low focus on upper limb rehabilitation after stroke and to understand the views of rehabilitation professionals (RPs) on the use of upper limb rehabilitation technologies for self-management of stroke.
Study Design
A qualitative descriptive design that employs a one-on-one semistructured interview method.
Methods
A total of nine RPs (physiotherapist n = 6 and occupational therapist n = 3) participated. Interviews were held in person or via teleconferencing, recorded, and transcribed verbatim. All transcribed data were analyzed using thematic analysis, with an inductive approach.
Results
The average length of practice years of the RPs in this study was 24.7 ± 9.8, with 16.44 ± 9.19 experience in neurological rehabilitation. The views gathered from all nine (9/9) RPs point to a low focus on upper limb rehabilitation for people living with stroke. In an inpatient setting, this was attributed to the rehabilitation goals/ priorities (of people living with stroke, RPs, and/or hospital’s rehabilitation/stroke units), inadequate resources, and the inability of the RPs to deal with the high incidence of stroke. After discharge, it was attributed to the cost of securing private rehabilitation and poor knowledge of technologies that can support self-rehabilitation. The cost, design, and inadequacy of evidence on the effectiveness of some available upper limb rehabilitation technologies were noted as reasons that could make it difficult for RPs to promote the use of rehabilitation technologies.
Conclusions
There is a low focus on upper limb rehabilitation after a stroke, particularly during the early stages, owing to the pursuit of early discharge which appears to attach higher priority to the lower limb in addition to inadequate resources and lack of capacity to deal with the high incidence of stroke.
期刊介绍:
The Journal of Hand Therapy is designed for hand therapists, occupational and physical therapists, and other hand specialists involved in the rehabilitation of disabling hand problems. The Journal functions as a source of education and information by publishing scientific and clinical articles. Regular features include original reports, clinical reviews, case studies, editorials, and book reviews.