Problematising risk in stroke rehabilitation

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Sociology of Health

Background:

• Rehabilitation after stroke often necessitates engaging with risk to achieve personally valued activities.
• Understanding risk is crucial for effective stroke rehabilitation, encompassing both positive and negative aspects.

Purpose of the Study:

• To identify dominant understandings of risk in stroke rehabilitation.
• To analyze assumptions underpinning these understandings and their impact on research and practice.
• To propose alternative conceptualizations of risk for improved stroke rehabilitation.

Main Methods:

• Employed Alvesson and Sandberg's method of problematisation.
• Included a historical overview of stroke rehabilitation.
• Utilized an iterative process of literature search, data extraction, synthesis, assumption identification, and alternative generation.

Main Results:

• Discussion of risk in stroke rehabilitation is predominantly implicit.
• Two key conceptualizations of risk identified: patient's risk of dependency and healthcare system's financial risk.
• These implicit views shape research and practice, focusing on impairment and generic approaches.

Conclusions:

• Implicit risk conceptualizations in stroke rehabilitation reinforce a focus on impairment and decontextualized care.
• This focus limits addressing broader life goals and may restrict access to rehabilitation.
• Alternative conceptualizations viewing individuals within relational networks offer wider rehabilitation possibilities.