Chinese elderly patients' perceptions of their rehabilitation needs following a stroke

Stroke is the third leading cause of death and disability among Chinese eld erly patients in Hong Kong and yet the rehabilitation needs of these patien ts are rarely explored. The aim of this study was to identify the rehabilit ation needs of Chinese elderly patients following a stroke. The study adopt ed an ethnographic approach, information being gathered by the researcher t hrough interviews with 15 key informants selected by purposive sampling. Th e perceptions of patients as to their own needs were sought at three stages of recovery - in the acute and rehabilitation settings and at 1 month foll owing discharge. Ethical approval was gained from the Chinese University Fa culty of Medicine ethical committee and access agreed by the hospital autho rities. Verbal approval was gained from the patients before each interview, following confirmation of the voluntary nature of participation and assura nce of confidentiality and anonymity. The researcher's role was also clearl y stated. Analysis of the interview data produced five categories of patien t need at the three stages of recovery, namely informational, physical, psy chological, social and spiritual. The most frequently stated, but largely u nmet, need in all settings was the need for information, particularly infor mation about the reasons for stroke and about the activities that promote r ecovery. In the acute and rehabilitation settings patients' responses indic ated a need to be respected as individuals, to be addressed by name and to be provided with privacy. Although the Barthel Index administered during in terviews charted recovery at different rates, nurses did not always make li nks between the level of functional ability and the help needed with physic al tasks. They also failed to recognize the relationship between physical a nd psychological needs and the equal importance of both in recovery from st roke. As Chinese elderly patients tend to take a passive role in seeking he lp and information, nurses play a significant role in the identification of individual rehabilitation needs. implications for nursing practice are dis cussed.