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      Healthcare Professionals' Experiences with Rehabilitation Practices for Patients with Cognitive Impairment after Stroke in North Norway: A Qualitative Study

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          Abstract

          Methods

          A focus group interview with clinicians, coordinators, and leaders involved in stroke survivors' rehabilitation trajectories was conducted. The group consisted of a strategic selection of participants with diverse professional backgrounds from specialist and primary healthcare services. The transcribed material was analyzed thematically using systematic text condensation based on an inductive, interpretive approach.

          Results

          We found that patients with mild and moderate cognitive impairment after stroke were characterized as a neglected group in rehabilitation services and that neglect was related to both structural and professional issues. First, neglect seemed partly related to the availability of existing healthcare services, which mainly followed up on physical challenges after stroke. Second, cognitive rehabilitation seemed to be less prioritized than other health services, and the established interdisciplinary municipality teams did not seem prepared to follow-up on cognitive issues. Finally, at a professional level, the study reveals the need for building competence in cognitive rehabilitation and having services available in the long run.

          Conclusion

          The study demonstrates the need to increase knowledge concerning cognitive rehabilitation and how rehabilitation trajectories and services should be organized to fulfil stroke survivors' and carers' long-term needs.

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          Most cited references43

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          A Tong, P SAINSBURY, J. Craig (2007)
          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Stroke rehabilitation.

            Peter Langhorne, Julie Bernhardt, Gert Kwakkel (2011)
            Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Systematic text condensation: a strategy for qualitative analysis.

              Kirsti Malterud (2012)
              To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies. Giorgi's psychological phenomenological analysis is the point of departure and inspiration for systematic text condensation. The basic elements of Giorgi's method and the elaboration of these in systematic text condensation are presented, followed by a detailed description of procedures for analysis according to systematic text condensation. Finally, similarities and differences compared with other frequently applied methods for qualitative analysis are identified, as the foundation of a discussion of strengths and limitations of systematic text condensation. Systematic text condensation is a descriptive and explorative method for thematic cross-case analysis of different types of qualitative data, such as interview studies, observational studies, and analysis of written texts. The method represents a pragmatic approach, although inspired by phenomenological ideas, and various theoretical frameworks can be applied. The procedure consists of the following steps: 1) total impression - from chaos to themes; 2) identifying and sorting meaning units - from themes to codes; 3) condensation - from code to meaning; 4) synthesizing - from condensation to descriptions and concepts. Similarities and differences comparing systematic text condensation with other frequently applied qualitative methods regarding thematic analysis, theoretical methodological framework, analysis procedures, and taxonomy are discussed. Systematic text condensation is a strategy for analysis developed from traditions shared by most of the methods for analysis of qualitative data. The method offers the novice researcher a process of intersubjectivity, reflexivity, and feasibility, while maintaining a responsible level of methodological rigour.
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                Author and article information

                Contributors
                Anniken Bogstrand:
                ORCID: https://orcid.org/0000-0003-3740-8408
                Journal
                Journal ID (nlm-ta): Rehabil Res Pract
                Journal ID (iso-abbrev): Rehabil Res Pract
                Journal ID (publisher-id): rerp
                Title: Rehabilitation Research and Practice
                Publisher: Hindawi
                ISSN (Print): 2090-2867
                ISSN (Electronic): 2090-2875
                Publication date Collection: 2022
                Publication date (Electronic): 10 September 2022
                Volume: 2022
                Electronic Location Identifier: 8089862
                Affiliations
                1Department of Health and Care Sciences, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037 Tromsø, Norway
                2Centre for Care Research, North, Department of Health and Care Sciences, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037 Tromsø, Norway
                3Department of Rehabilitation, University Hospital of North Norway, 9038 Tromsø, Norway
                4Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037 Tromsø, Norway
                5Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), University of Oslo, Oslo, Norway
                6Hammel Neurorehabilitation Centre and University Research Clinic, University of Aarhus, Voldbyvej 15, DK-8450 Hammel, Denmark
                Author notes

                Academic Editor: Valentina Varalta

                Author information
                https://orcid.org/0000-0003-3740-8408
                https://orcid.org/0000-0002-2301-5067
                https://orcid.org/0000-0002-2491-2560
                https://orcid.org/0000-0002-3531-2536
                https://orcid.org/0000-0002-8194-0437
                Article
                DOI: 10.1155/2022/8089862
                PMC ID: 9482544
                PubMed ID: 36124079
                SO-VID: fa8df1b0-2f88-4b19-b4e6-23953cb5df9c
                Copyright © Copyright © 2022 Anniken Bogstrand et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 February 2022
                Date accepted : 31 August 2022
                Funding
                Funded by: UiT-The Arctic University of Norway
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Health & Social care
                Data availability:
                ScienceOpen disciplines: Health & Social care

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