Post Stroke Survivors' Experiences of the First Four Weeks During the Transition Directly Home From the Hospital

Abstract

Purpose: The purpose of this qualitative descriptive study was to investigate the experiences of post stroke survivors (PSSs) during transition from hospital discharge home during the first four weeks. Background: PSSs describe the transition from hospital to home as an important time in recovery and stress various physical and cognitive concerns early within the recovery period. Research to date fails to adequately reflect PSSs' experiences early after discharge home. This gap in research limits the ability to create interventions for PSSs during this critical time period. Methods/analysis: Semi-structured telephone interviews were conducted with 31 participants, recruited from a large metropolitan hospital in the northeastern United States. The use of in-vivo codes lead to the development of themes that described PSSs' experiences during the four week transitional period. Credibility and transferability of findings were strengthened through memoing, field notes, reflexivity of analysis, member checking, and peer review throughout the analysis process by qualitative experts. Results: The five major themes were: (a) the shock of a stroke interrupting a normal day, (b) transition to an unfamiliar home, (c) experiencing a life riddled with uncertainty, (d) a journey to a new sense of self, and (e) adjusting to a new sense of self. Throughout their journey all PSSs had to cope with uncertainty and adjust to a new sense of self. PSSs that experienced less uncertainty were able to return to their prior daily routine, knew how to prevent another stroke, had a helpful support system, and had frequent follow-up and communication with health care professionals. Conclusion: All PSSs are at risk for complications regardless of stroke severity. To address PSSs complex needs, nurses can provide care beyond symptom management by fostering a dynamic intentional relationship to support recovery. The framework resulting from this study can provide the platform for advanced neuroscience nurses to engage with PSSs to improve their recovery and adjustment to a new sense of self as they transition from hospital to home.