Stroke survivors' experiences of occupation in hospital-based stroke rehabilitation: a qualitative exploration

Purpose: Studies highlighting the time spent in self-isolating and inactive activities during stroke rehabilitation have led to the introduction of group programs and environmental enrichment to improve activity levels. A less explored perspective is to understand how the introduced changes align with the occupational needs of the stroke survivors. Therefore, the aim of this study was to explore stroke survivors experiences of engagement in occupations during stroke rehabilitation.Methods: A descriptive phenomenological approach with semi-structured interviews explored stroke survivors experiences.Results: Eight participants (five male and three female, mean age 72 years) described their experiences with two themes emerging: (1) "I'm here for that reason:" which highlighted therapy as an occupation which participants wanted to perform and (2) "Celebration of quiet moments:" exploring the value of rest and recreation.Conclusion: This study provides a preliminary understanding of how stroke survivors experience occupational engagement during rehabilitation. There was an apparent shift in priorities with therapy considered the most important occupation and a strong need expressed for rest and relaxation to be factored into people's days. It appears the increasing activity levels may not always align with people's occupations and that due consideration of this malalignment may further enhance engagement and outcomes.Implications for rehabilitationDuring hospital-based stroke rehabilitation, stroke survivors prioritized the occupations of therapy, rest, and recreation.People with stroke are motivated to participate when the activities within and outside of, therapy align with their pre-stroke life and occupations.A daily stroke rehabilitation program should be balanced with opportunities for rest to support recovery time from therapy and possible consolidation of learning.