The Provision of Feedback in Community Stroke Rehabilitation: The Therapists’ Perspective

Background and Purpose: The provision of feedback from the therapist to the patient during post-stroke rehabilitation necessitates astute clinical reasoning and decision making (CRDM). Therefore, if innovative methods of promoting selfmanaged rehabilitation, such as the use of technology, are to effectively augment therapeutic practice, understanding the CRDM underpinning the provision of feedback is essential. This research explores the CRDM underpinning the provision of feedback during community-based post-stroke rehabilitation by gaining the perspectives of Community Stroke Teams. Methods: Qualitative data analysis from two focus groups using thematic analysis was used to identify major themes. Purposeful sampling was used to recruit community-based individual Occupational therapists (OT) and Physiotherapists (PT) that were specifically involved in facilitating physical rehabilitation to stroke survivors in the patients’ home (n=14). Results: Four major themes emerged: the delivery of feedback; adapting feedback to the individual; carers involvement; enabling self-management: the influence of the therapist. Therapists reported providing visual, verbal and tactile (hands-on) feedback which was adapted to the individual’s personal and environmental context. However, the focus groups also highlighted how therapists control the rehabilitation process; what they include and who they include. Discussion: In accordance with the ICF model, data suggest the CRDM when providing feedback for stroke rehabilitation in the community is underpinned by the medical, social and contextual components of health. However, how therapists control the rehabilitation process; what they include and who they include is often led by the therapist. This learning experience may impact on further rehabilitation experience(s) or contemporary models of care delivery; such as, autonomous rehabilitation using technology.