Exploring participation in occupations of clients who sustained a stroke one-year after discharge from inpatient care in Malta

Abstract

Background. Stroke is one of the leading causes of death and disability. It affects the survivors, as well as their families in social, economic, and emotional aspects. Following discharge from an inpatient rehabilitation facility, difficulties, such as the necessity of using adapted equipment, dependence on others in daily occupations, and changes in social roles may persist. Purpose. This study aimed to evaluate the degree of occupational engagement among stroke survivors one year after being discharged from inpatient rehabilitation. It also sought to assess functional abilities, challenges, and rehabilitation outcomes, pertaining to everyday occupations, including personal and instrumental activities of daily living. Method. This study adopted a qualitative approach. The data was collected through conducting semi-structured interviews with five individuals who had sustained a stroke, a year after being discharged from inpatient care. The participants were recruited by the intermediary, through the method of purposeful sampling. The data was then analysed using the thematic analysis technique described by Braun and Clarke (2006). Results. Through thematic analysis, three overarching themes emerged from the interviews, ‘Adaptation and Coping Strategies’, ‘Changes in Daily Life and Routines’, and ‘Aspects of Adjustment’. The results underscored the impact of the stroke on the survivors’ independence in everyday occupations, which could be improved with the use of adaptive equipment. The impact of stroke also inflicted major disruptions to the daily routines and autonomy of the participants, with many resorting to the comfort of their homes. Accepting limitations, resilience, determination, and strong support networks were essential aspects in adaptation. Implications. This research explores the experiences of stroke survivors, highlighting their daily difficulties and well-being. It emphasises how crucial adaptive equipment and support networks, including occupational therapy, are in helping them adjust and recover. These revelations provide occupational therapists with a better understanding of the effects of stroke, a year post discharge.