Gateway to Recovery: A Comparative Analysis of Stroke Patients’ Experiences of Change and Learning in Norway and Denmark

Abstract

Objectives The recovery process is reported by stroke survivors to be a change process fraught with crises and hazard. Interaction with health professionals and others may play a central role in establishing renewed control over life. Research Questions (1) How do patients handle and overcome experienced changes after stroke? (2) How do they experience the support to handle these changes during the first year after stroke? (3) How do the similarities and differences transpire in Danish and Norwegian contexts? Methodology. A qualitative method was chosen. Six patients from Denmark and five patients from Norway (aged 25-66) were followed up until one year after stroke, by way of individual interviews. The data were analyzed (using NVivo 11) by means of phenomenological analysis. Findings The participants described four main issues in the recovery process that impacted the experienced changes: (i) strategies and personal factors that promote motivation, (ii) the involvement of family, social network, and peers, (iii) professionals' support, and (iv) social structures that limit the recovery process. There was a diversity of professional support and some interesting variations in findings about factors that affected recovery and the ability to manage a new life situation between Central Denmark and Northern Norway. Both Norwegian and Danish participants experienced positive changes and progress on the bodily level, as well as in terms of activity and participation. Furthermore, they learned how to overcome limitations, especially in bodily functions and daily activities at home. Unfortunately, progress or support related to psychosocial rehabilitation was almost absent in the Norwegian data.

Understanding Therapeutic Sensory Stimulation Garden (TSSG) as a Rehabilitation Garden in a Healthcare Centre

“…It seems that the activity was planned to suit the patient's individual needs. This finding was consistence with the suggestion made by [22], where it was suggested that the intervention activities should include a patient's self-management approach, involving meaningful activities and tailored to the individual patients. In these sessions, patients were observed to perform walking tasks using a walking stick or walking frame at the center part of C2 and using the route around the pergola, assisted by therapists at their side to support their balancing.…”

“…This activity was observed to encourage patients to communicate with peers and boost their confidence level. Group interventions that are well organized and structured played an important role to help patients to develop their cognitive and social abilities [22]. Meanwhile, the activities carried in GS2 were observed to focus more on physical intervention, which involved rule games such as Bowling, Snake and Ladder, and Bean Bag Toss games.…”

“…These sessions supported the sense of control element as suggested by [18] in Theory of Supportive Garden. Individual customization helps patients themselves to gain control over their chosen activities [22]. Fig.…”

“…These activities helped to assist the main issues of sensorimotor impairments. Walking, strength, endurance, coordination and hand functions were associated as the main issues faced by neurology patients [22]. Apart from that, patients were also exposed to sensory stimulation activities at the center of C2.…”

Factors related to met needs for rehabilitation 6 years after stroke

“…However, as needs identified by health professionals have been reported not to capture all those identified by people with stroke [23], the individual's perspective should also be included as recommended by WHO [24]. In partnership with the healthcare professionals, the patients with stroke should be actively involved in the rehabilitation process, be able to express their needs and values, and have the opportunity to make informed decisions about their rehabilitation [21,[25][26][27][28]. Involving patients in shared decision-making has been reported to increase patient satisfaction and motivation, and create a greater sense of ownership [12,[29][30][31][32].…”