Every survivor that writes about recovery states it is extremely hard, repetitive and time-consuming. Don't doctors and therapists understand that that needs to be forcefully communicated to all survivors? Along with the fact that magic doesn't occur. If
you don't do the work, you won't recover.
http://medicalxpress.com/news/2014-07-barriers-post-stroke.html
For stroke victims, rehabilitation is crucial to their recovery. But a
Flinders University study conducted in Singapore found that
rehabilitation rates following discharge from hospital are poor because
of gaps in the continuum of stroke care.
The study – published last month in the
International Journal of Therapy and Rehabilitation
– identified five major barriers to post-stroke rehabilitation in
Singapore including; difficulties accessing rehabilitative services;
gaps in discharge coordination; the influence of family members;
discrepancies in expectation; and the perception that rehabilitation is
simple.
As part of the research, interviews were conducted with 68
stroke victims
who were discharged from a Singapore rehabilitation unit between
December 2012 and April 2013. Of those, 31 participants reported not
following recommendations to continue their rehabilitation. There was no
difference in gender, age or type of stroke between those who did and
not complete the rehabilitation.
Flinders Clinical Rehabilitation lecturer Dr Christopher Barr, a
co-investigator of the study, said access barriers, including mobility
difficulties and transport costs, along with affordability of services,
were the chief obstacles precluding rehabilitation.
"The lack of transport means and the associated costs were the main
barriers that hindered adherence to continuing post-stroke
rehabilitation," Dr Barr said.
"Affordability of services also had a direct influence, with one
participant's family member stating: 'money is a concern and also who
[is going] to bring my dad to therapy'," he said.
"Gaps in the transition from hospital to outpatient services were
also cited as a reason for not continuing rehabilitation – in some cases
participants fell through the unnoticed gap and were left waiting for
follow-up appointments."
Dr Barr said family members were either facilitators or inhibitors of
rehabilitation: "One participant said they have to prompt their mother
to go because they think it's good for her but another participant said
they missed two appointments because their son forgot.
"It wasn't uncommon for patients and carers to feel stranded and helpless."
Dr Barr said most participants regarded rehabilitation as simple,
common-sense knowledge that could easily be self-replicated or
substituted without the help of a therapist, leading them to seek
alternatives to their therapy recommendation.
He said the findings highlighted the need to review current
goal-setting processes for rehabilitation and the need to establish a
common understanding of rehabilitation practice between patients, carers
and clinicians.
"Clinicians need to be more aware of their role in providing
well-coordinated information about therapy, and goals need to be more
patient-centred to reduce the discrepancies in expectations of
rehabilitation.
"Carers also need to be more empowered and involved in discharge
planning to minimise the dissatisfaction in care arrangements and
information delivery."
