Functioning in everyday life after stroke: a longitudinal study of elderly people receiving rehabilitation at home.
OBJECTIVE
There is a need to identify different rehabilitation needs over time among individuals with stroke in order to implement client-centred rehabilitation interventions after stroke. The objective of this research was to describe changes in some aspects of functioning and to explore the patterns of change in functioning in everyday life during the first year after stroke for elderly patients participating in rehabilitation at home.


METHODS
Patients who fulfilled the inclusion criteria for a regular rehabilitation-at-home programme after stroke were considered for participation in this study. Twenty-seven elderly patients participated on four data collection occasions during the year immediately subsequent to a stroke. The mean age of the 27 participants was 78.8 years (SD = 5.9) and 67% of the participants were women.


METHODS
Data on certain aspects of functioning were collected and a person-oriented approach was used to describe the patterns in the change in functioning for individuals.


RESULTS
Four different patterns were identified: (a) moderate change in functioning (n = 4), (b) minor change in functioning (n = 11), (c) minor change despite major life event (n = 7), (d) disrupted change in functioning (n = 5). The study group improved significantly in most aspects of functioning, but still, most participants (n = 20) showed dissatisfaction with life as a whole 12 months after their stroke.


CONCLUSIONS
This study identified different patterns of change in functioning in everyday life. This knowledge should serve to help guide rehabilitation professionals in their assessment of clients' needs during different phases after stroke.
Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Sweden. lisa.ekstam@ki.se
Lisa
L
Ekstam
Brittmari
B
Uppgard
Lena
L
von Koch
Kerstin
K
Tham
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008016:Life Change Events; D008297:Male; D051346:Mobility Limitation; D020380:Needs Assessment; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration; D010549:Personal Satisfaction; D011446:Prospective Studies; D020127:Recovery of Function; D020377:Self Efficacy; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013548:Sweden