A Longitudinal Qualitative Study of Resourcefulness Training Needs During the Hospital-to-Home Transition After Stroke in Young and Middle-Aged Adults

Abstract

Introduction: Resourcefulness training (RT) supports stroke recovery by improving coping strategies and self-management. Recognising the need for such training is crucial for providing targeted transitional care. We aimed to explore the evolving need for RT among young and middle-aged stroke survivors during their transition from hospital to home. Methods: Using purposive sampling, we conducted two rounds of semi-structured face-to-face interviews, supplemented by observational methods, involving 21 young and middle-aged stroke survivors and 13 informal caregivers. Data were collected at two time points: 1–3 days before hospital discharge (T1) and 2 months after returning home (T2). Thematic analysis was conducted, and NVivo 12 was used to facilitate data coding and organisation. Results: Longitudinal qualitative analysis revealed two interconnected and fluid psychosocial stages in the transition from hospital to home: a vulnerable window immediately after discharge and an open period for rebuilding the rhythm of life. Each stage encompassed two major themes and four sub-themes: (1) crisis awareness: limited coping capacity and concerns regarding stroke recovery; (2) low participation in rehabilitation training: limited initiative towards rehabilitation and insufficient awareness of available social resources; (3) repositioning needs: adjustment and reconstruction of self-perception, along with a desire for self-actualisation; and (4) desire for social support: assistance with behavioural change and the pursuit of community acceptance. Conclusion: These findings indicate that the need for RT for young and middle-aged stroke survivors during the hospital-to-home transition evolves dynamically from personal to social resourcefulness. Enhancing disease awareness during hospitalisation, gradually integrating social support resources after discharge, and tailoring interventions according to age, sex and rehabilitation status may better meet the rehabilitation needs of this population as they transition to home care. Patient or Public Contribution: Patients and caregivers were actively involved in the feedback and early phases of data analysis. They verified the accuracy and relevance of the analysed themes. The medical staff provided respondent names and bed information that met the inclusion criteria. Their involvement contributed to ensuring the accuracy of data collection and enhancing the validity of the results.