Re-thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory framework

The dramatic effects of a stroke can have far-reaching implications for pat ients and carers. Effective recovery involves a considerable array of copin g strategies that facilitate and promote engagement in the social world. Th eir development is a long-term process that requires considerable effort, m otivation and enterprise on the part of patients and their families. Tradit ional approaches to the provision of stroke rehabilitation services, howeve r, appear to be underpinned by frameworks that are short-term in outlook. A s a consequence, nursing interventions often focus on the progression of th e patient through the care system, rather than on facilitating future recov ery. Much of the work of stroke recovery is consequently done by patients a nd their families at home, with little provision of ongoing professional he lp and advice. This paper explores the application of the Corbin and Straus s Chronic Illness Trajectory Framework for stroke. In particular, the major concepts of the framework are applied to a vignette derived from a longitu dinal study of patients' experiences of recovery. The trajectory framework is shown to be a useful structure that has the potential to enhance the app ropriateness of nursing interventions for stroke patients. However, the val idity of the framework can only be established through its application and evaluation in clinical practice. The purpose of this paper is to contribute to a debate that encourages consideration of the framework's utility for n urses to enhance the stroke rehabilitation experience.