How can stroke care be improved for younger service users? A qualitative study on the unmet needs of younger adults in inpatient and outpatient stroke care in Australia

Abstract

Background: The incidence of young stroke is increasing worldwide. However, young adults are inadequately supported in their recovery by a system of stroke care in which the older patient is the majority consumer.

Purpose: To examine the unmet needs of younger stroke survivors in inpatient and outpatient healthcare settings and identify opportunities for improved service delivery.

Materials and Methods: In-depth semi-structured interviews were undertaken with 19 participants aged 18–55 at the time of their first-ever stroke and inductively analysed using a rigorous qualitative descriptive approach.

Results: Many unmet care needs were identified within three emergent themes: inadequately addressed psycho-emotional and cognitive needs after young stroke; isolation from lack of information and structured support; and failure to deliver age-relevant patient-centred care. These themes were further divided into sub-themes and the sub-themes were named in a manner to signpost the way forward for young stroke care.

Conclusions: This study provides new insights into the experience of inpatient and outpatient stroke care by younger stroke survivors and outlines possible improvements for clinical practice. Future research should evaluate the effect of targeted strategies to support younger adults after stroke.

Implications for rehabilitation

• Post-stroke rehabilitation might be improved by providing more support for the non-physical effects of stroke (e.g., psycho-emotional support, cognitive rehabilitation).

• Younger stroke survivors may also benefit from a long-term community care plan and longer-term rehabilitation.

• Patient-centered rehabilitation and education about self-management interventions appear to be important areas for further development.

• Future research is required to evaluate the effect of targeted strategies to support younger stroke survivors, as well as identify the needs of younger adults with post-stroke communication impairment.

Keywords:

• Stroke
• young adult
• needs assessment
• long-term needs
• inpatient
• outpatient
• stroke care
• qualitative research

Acknowledgements

We thank the study participants for sharing their personal experiences and the staff at the FINMH and Austin Hospital for their support of this research. The FINHM acknowledges the infrastructure support of the Victorian State Government.

Disclosure statement

The authors report no declarations of interest. J.B. was supported by an NHMRC Established Research Fellowship [grant number N1058635]. This research received no other specific grant from any funding agency in the public, commercial, or not-for-profit sectors.