An Exploration of Quality of Life Contributors for Stroke Survivors: Potential Implications for Service Delivery Within the Community Rehabilitation Context

Abstract

Purpose: Community rehabilitation services typically assist stroke survivors with function, participation, and quality of life. Many factors have been found to influence the overall quality of life including self-identity, control, social supports, personality, and participation in valued activities. This review explored the possible contributing quality of life factors for stroke survivors within a community rehabilitation context to assist with further development of service delivery within this clinical area. Method: A purposive sample of clients with stroke (n=20) was selected based on their overall quality of life change during their rehabilitation program as measured on the World Health Organisation Quality of Life Questionnaire. Clients with the largest positive and negative quality of life changes were included. A clinical record review of client medical records was undertaken of these stroke survivors to identify and describe common themes that may be related to quality of life. Results: Five general themes emerged relating to possible contributing factors to quality of life for clients participating in this community stroke rehabilitation setting including transiting between hospital and community, flexibility of service delivery model, strength of family and household relationships, acceptance and expectation of both service delivery and functional levels, and ongoing co-morbid medical issues. Conclusions: This review suggests that community rehabilitation service models of care should be flexible and tailored to client needs and goals to enable a true “client-centered” approach. Social and behavioural paradigms should be incorporated within the community rehabilitation settings. Services should focus on personal factors such as the stroke survivor's adjustment to their situation, personality factors, and outcome expectations. Consideration also needs to be given to the overall continuum of care of health care services.