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Determining the Needs, Priorities, and Desired Rehabilitation Outcomes of Young Adults Who Have Had a Stroke

DOI: 10.1155/2012/963978

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Abstract:

Background. Guidelines state that young adults' (aged 18–55 years) rehabilitation needs and priorities following stroke are different from older adults'. However, there is a lack of evidence regarding young adults' perspectives of their needs and priorities. Aim. To gain an understanding of young adults' experience of stroke and associated rehabilitation needs, priorities, and desired outcomes. Methods. A qualitative approach was adopted, based on the phenomenology of Merleau-Ponty. Longitudinal data were gathered using unstructured interviews and analysed using phenomenological reduction. Results. Ten young adults took part in up to four interviews over two years. An overarching theme, Embodied Disorientation, and three subthemes: Mortal Body, Situated Body, and Embodied Perception of Difference, described the young adults' experience. A subsequent iterative process enabled tabulation of patient-centred rehabilitation needs, priorities, and outcomes. Conclusion. Rehabilitation professionals can use the evidence-based outcomes table to work with young adults to develop meaningful patient-centred goals and select appropriate interventions which align with identified needs and outcomes throughout the stroke recovery trajectory. 1. Introduction Stroke is a common, long-term condition, which is a principal cause of complex disability amongst those living in the community [1]. Stroke may affect physical, cognitive, and emotional functions and often causes major disruption to the life course [2]. It is often perceived to be a condition of older age, yet it is prevalent amongst younger adults, that is adults aged between 18 and 55 years [3]. Traditionally, the design and delivery of stroke services, both acute care and long-term rehabilitation, have reflected the needs and priorities of older adults. Increasingly, however, it is suggested that young adults’ rehabilitation needs and priorities following stroke differ from those of older adults [4, 5], particularly in relation to parenting [6] and employment [7, 8]. An additional differentiating feature is that survival rates are high for young adults and, as a result, young adults are more likely to live longer with the physical, psychological, and social consequences of stroke [9]. Surveys conducted exclusively with young adults (aged 18–65), reported a range of unmet needs including personalised information about stroke, intellectual fulfilment, access to rehabilitation therapies, and opportunities for social reintegration [9, 10]. Qualitative studies conducted exclusively with young adults found that

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