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Designing stroke services for the delivery of cognitive rehabilitation: a qualitative study with stroke rehabilitation professionals

This qualitative study explored the potential to deliver cognitive rehabilitation for post-stroke cognitive impairment (PSCI), with a specific focus on barriers and facilitators to its delivery from the perspective of Irish stroke rehabilitation professionals. Sixteen semi-structured interviews were completed with healthcare professionals in both hospital and community settings. The sample comprised physiotherapists, occupational therapists, nurses, a stroke physician, a psychologist, a neuropsychologist, a speech and language therapist, a dietician, and a public health nurse. Interviews were audio-recorded and analysed in NVivo using inductive Thematic Analysis. Barriers and facilitators to the delivery of cognitive rehabilitation were identified and described under four key themes: (i) Cognitive screening; (ii) Cognitive rehabilitation: no one size fits all; (iii) Psychology: the lost dimension of stroke rehabilitation; and (iv) Joining the dots in the community. Staffing required to deliver cognitive rehabilitation for PSCI was highlighted as under-resourced in the Republic of Ireland. Inadequate resourcing of neuropsychology and stroke-related psychological services, in particular, has had negative implications for the delivery of cognitive rehabilitation. Stroke-specific cognitive rehabilitation expertise is virtually inaccessible in the community, highlighting an urgent need for investment in specialist rehabilitation teams to deliver cognitive rehabilitation in this setting.

Funding

Health Research Board SPHeRE/2013/1

History

Comments

This is an Accepted Manuscript of an article published by Taylor & Francis in Neuropsychological Rehabilitation on 14 Oct 2021, available online: http://www.tandfonline.com/doi.org/10.1080/09602011.2021.1977155.

Published Citation

Jeffares I, Merriman NA, Doyle F, Horgan F, Hickey A. Designing stroke services for the delivery of cognitive rehabilitation: a qualitative study with stroke rehabilitation professionals. Neuropsychol Rehabil. 2021 14:1-24.

Publication Date

14 October 2021

PubMed ID

34648412

Department/Unit

  • Health Psychology
  • School of Physiotherapy

Research Area

  • Population Health and Health Services

Publisher

Informa UK Limited

Version

  • Accepted Version (Postprint)