Exercise rehabilitation experience of stroke patients：a qualitative meta-synthesis

doi:10.3761/j.issn.0254-1769.2024.11.017

Abstract

Abstract:

Objective To systematically evaluate the qualitative research on the experience and feeling of elderly patients with hip fracture during rehabilitation. Methods We searched databases including the PubMed，Embase，Web of Science，Cochrane Library，CNAIHL，CNKI，Wanfang，VIP，SinoMed. The literature of qualitative research on the exercise rehabilitation experience of stroke patients from the establishment of the database to August 17，2023 was retrieved. Results A total of 59 clear research topics were extracted，and 14 new categories were formed after induction and integration，which were finally merged into 5 integrated results. Integration results 1：Perceived benefits of exercise rehabilitation. Integration results 2：Multiple driving forces of exercise rehabilitation. Integration results 3：Gradual loss of patience in long-term rehabilitation. Integrated results 4：Generating new rehabilitation needs and actively coping with them. Integrated results 5：There are many difficulties in carrying out self-rehabilitation. Conclusion During the process of exercise rehabilitation for stroke patients，medical personnel should pay attention to the patients’ actual feelings，inner needs，and the practical challenges they face in participating in exercise rehabilitation. Personalized exercise rehabilitation facilitation strategies should be developed for stroke patients，aiming for the scientific and precise advancement of exercise rehabilitation，and ultimately improving long-term rehabilitation outcomes for patients.

Key words: Stroke, Exercise Rehabilitation, Qualitative Research, Meta Integration, Evidence-Based Nursing

摘要：

目的系统评价和整合脑卒中患者参与运动康复的真实体验，为进一步开展脑卒中患者运动康复助推策略及相关实践提供参考。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNAIHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于脑卒中患者康复过程的经历、体验及相关心理状态的质性研究，检索时限为建库至2023年8月17日。结果共纳入10篇文献，提炼59个研究结果，归纳为14个新类别，综合成5个整合结果：感知运动康复的益处；运动康复的多元驱动力；在长期康复中逐渐失去耐性；产生新的康复需求并积极应对；开展自我康复困境重重。结论医护人员应关注脑卒中患者运动康复过程中的真实感受、内心需求及运动康复参与的现实困境，针对脑卒中患者制订个性化的运动康复助推策略，实现运动康复科学化、精准化，改善患者远期康复结局。

关键词: 脑卒中, 运动康复, 质性研究, Meta整合, 循证护理学

SHI Huiling, WANG Qing, JIANG Yuanyuan, ZHANG Min, DAI Yuting, JI Kangling. Exercise rehabilitation experience of stroke patients：a qualitative meta-synthesis[J]. Chinese Journal of Nursing, 2024, 59(11): 1397-1404.

史慧玲, 王清, 蒋园园, 张敏, 戴雨婷, 吉康菱. 脑卒中患者运动康复体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(11): 1397-1404.

Figures/Tables 5

Figure 1 PubMed search query

Figure 2 CNKI search query

Figure 3 Literature screening process

Table 1 Basic features of the included literature（n=10）

Table 2 Methodological quality evaluation of the included literature（n=10）

References 28

[1]	Selves C, Stoquart G, Lejeune T. Gait rehabilitation after stroke:review of the evidence of predictors,clinical outcomes and timing for interventions[J]. Acta Neurol Belg, 2020, 120(4):783-790. DOI PMID
[2]	O’dell MW. Stroke rehabilitation and motor recovery[J]. Contin-uum(Minneap Minn), 2023, 29(2):605-627.
[3]	健康中国行动推进委员会. 健康中国行动(2019—2030年):总体要求、重大行动及主要指标[J]. 中国循环杂志, 2019, 34(9):846-858.
	Healthy China Action Promotion Committee. Healthy China Action(2019-2030):overall requirements,major actions and key indicators[J]. Chin J Cardiocirc, 2019, 34(9):846-858.
[4]	Chouliara N, Fisher R, Crosbie B, et al. How do patients spend their time in stroke rehabilitation units in England? The REVIHR study[J]. Disabil Rehabil, 2021, 43(16):2312-2319. DOI
[5]	盛晗, 邵圣文, 王惠琴, 等. 脑卒中患者康复锻炼依从性动态变化的研究[J]. 中华护理杂志, 2016, 51(6):712-715.
	Sheng H, Shao SW, Wang HQ, et al. A study on the rehabili-tation exercise compliance curve in stroke patients[J]. Chin J Nurs, 2016, 51(6):712-715.
[6]	Boyne P, Billinger SA, Reisman DS, et al. Optimal intensity and duration of walking rehabilitation in patients with chronic stroke:a randomized clinical trial[J]. JAMA Neurol, 2023, 80(4):342-351.
[7]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018.
	Hu Y, Hao YF. Evidence-based nursing[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[8]	Lockwood C, Munn Z, Porritt K. Qualitative research synthesis[J]. Int J Evid Based Healthc, 2015, 13(3):179-187.
[9]	Smith M, Scott A, Mellish S, et al. Understanding the experien-ces of people living with stroke engaging in a community-ba-sed physical-activity programme[J]. Healthcare(Basel), 2023, 11 (2):154.
[10]	Lin SL, Wang CL, Wang QM, et al. The experience of stroke survivors and caregivers during hospital-to-home transitional care:a qualitative longitudinal study[J]. Int J Nurs Stud, 2022, 130:104213.
[11]	Solbakken LM, Nordhaug M, Halvorsen K. Patients’ experiences of involvement,motivation and coping with physiotherapists during subacute stroke rehabilitation:a qualitative study[J]. Eur J Physiother, 2023, 25(3):154-161.
[12]	Kelly J, Dowling A, Hillier S, et al. Perspectives on rehabili-tation for Aboriginal people with stroke:a qualitative study[J]. Top Stroke Rehabil, 2022, 29(4):295-309.
[13]	Last N, Packham TL, Gewurtz RE, et al. Exploring patient perspectives of barriers and facilitators to participating in hospital-based stroke rehabilitation[J]. Disabil Rehabil, 2022, 44(16):4201-4210.
[14]	van Dongen L, Hafsteinsdóttir TB, Parker E, et al. Stroke sur-vivors’ experiences with rebuilding life in the community and exercising at home:a qualitative study[J]. Nurs Open, 2021, 8(5):2567-2577.
[15]	Chang FH, Lin YN, Liou TH. Recovery after stroke:perspec-tives of young stroke survivors in Taiwan[J]. Disabil Rehabil, 2022, 44(10):1976-1983.
[16]	Walder K, Molineux M. Listening to the client voice:a con-structivist grounded theory study of the experiences of client-centred practice after stroke[J]. Aust Occup Ther J, 2019, 67(2):100-109.
[17]	Purcell S, Scott P, Gustafsson L, et al. Stroke survivors’ expe-riences of occupation in hospital-based stroke rehabilitation:a qualitative exploration[J]. Disabil Rehabil, 2020, 42(13):1880-1885. DOI PMID
[18]	Mairami FF, Warren N, Allotey PA, et al. Contextual factors that shape recovery after stroke in Malaysia[J]. Disabil Reha-bil, 2020, 42(22):3189-3198.
[19]	Hunter RF, Tang J, Hutchinson G, et al. Association between time preference,present-bias and physical activity:implications for designing behavior change interventions[J]. BMC Public Health, 2018, 18(1):1388. DOI PMID
[20]	朱金凤, 蔡卫新, 陶子荣, 等. 中青年出血性脑卒中患者康复运动依从性现状及其影响因素分析[J]. 中华护理杂志, 2023, 58(5):580-586. DOI
	Zhu JF, Cai WX, Tao ZR, et al. Analysis of rehabilitation exe-rcise compliance and its influencing factors in young and middle-aged patients with hemorrhagic stroke[J]. Chin J Nurs, 2023, 58(5):580-586.
[21]	Corbett CM, Somers TJ, Nuñez CM, et al. Evolution of a longi-tudinal,multidisciplinary,and scalable patient navigation ma-trix model[J]. Cancer Med, 2020, 9(9):3202-3210.
[22]	Deen T, Terna T, Kim E, et al. The impact of stroke nurse navigation on patient compliance postdischarge[J]. Rehabil Nurs, 2018, 43(2):65-72. DOI PMID
[23]	Platz T. Evidence-based guidelines and clinical pathways in stroke rehabilitation:an international perspective[J]. Front Neurol, 2019, 10:200.
[24]	Karl FM, Holle R, Schwettmann L, et al. Time preference,out-come expectancy,and self-management in patients with type 2 diabetes[J]. Patient Prefer Adherence, 2018, 12:1937-1945.
[25]	Adans-Dester C, Hankov N, O’Brien A, et al. Enabling preci-sion rehabilitation interventions using wearable sensors and machine learning to track motor recovery[J]. NPJ Digit Med, 2020,3:121.
[26]	Signal NEJ, McLaren R, Rashid U, et al. Haptic nudges in-crease affected upper limb movement during inpatient stroke rehabilitation:multiple-period randomized crossover study[J]. JMIR Mhealth Uhealth, 2020, 8(7):e17036.
[27]	Mahmood A, Nayak P, English C, et al. Adherence to home exercises and rehabilitation(ADHERE) after stroke in low-to-middle-income countries:a randomized controlled trial[J]. Top Stroke Rehabil, 2022, 29(6):438-448.
[28]	Levy T, Laver K, Killington M, et al. A systematic review of measures of adherence to physical exercise recommendations in people with stroke[J]. Clin Rehabil, 2019, 33(3):535-545. DOI PMID