Transition Experiences of Stroke Survivors
Following Discharge Home
Maude Rittman, Craig Boylstein, Ramon Hinojosa, Melanie Sberna Hinojosa, and Jolie Haun
Top Stroke Rehabil 2007;14(2):21–31
© 2007 Thomas Land Publishers, Inc.
www.thomasland.com
doi: 10.1310/tsr1402-21
21
Maude Rittman, PhD, is Chief Nurse for Research, North
Florida/South Georgia Veterans Health System, VA
Rehabilitation Outcomes Research Center of Excellence, North
Florida/South Georgia Veterans Health System, Gainesville,
Florida.
Craig Boylstein, PhD, is Associate Investigator, North Florida/
South Georgia Veterans Health System, VA Rehabilitation
Outcomes Research Center of Excellence, North Florida/South
Georgia Veterans Health System, Gainesville, Florida.
Ramon Hinojosa, PhD(c), is Research Assistant, North Florida/
South Georgia Veterans Health System, VA Rehabilitation
Outcomes Research Center of Excellence, North Florida/South
Georgia Veterans Health System, Gainesville, Florida.
Melanie Sberna Hinojosa, PhD, is Investigator, North Florida/
South Georgia Veterans Health System, VA Rehabilitation
Outcomes Research Center of Excellence, North Florida/South
Georgia Veterans Health System, Gainesville, Florida.
Jolie Haun, PhD(c), is Research Assistant, North Florida/South
Georgia Veterans Health System, VA Rehabilitation Outcomes
Research Center of Excellence, North Florida/South Georgia
Veterans Health System, Gainesville, Florida.
S
troke is a leading cause of severe, long-term
disability in the United States.
1,2
Approximately 80% of stroke survivors are
discharged home to continue recovery, yet little is
known about experiences of stroke survivors
during the transition period after discharge
home.
3–6
The purpose of this article is to describe
three domains of psychosocial experiences of
stroke survivors during the first month following
discharge for acute stroke. Data were obtained
from a multisite study to develop culturally
sensitive models of stroke recovery across 2 years
after discharge home.
Transition is a passage from one life phase, con-
dition, or status to another and is embedded in the
context of a particular situation.
7
A salient feature
of a transition is that there is usually a triggering
event that initiates a change in the way individuals
look at themselves and their life situations.
8
The
occurrence of a stroke is a triggering event that is
accompanied by family members being focused
initially on survival of the stroke victim during the
acute phase of treatment. Once the family sees that
the loved one will survive, they begin to anticipate
changes needed after discharge and the stroke sur-
vivor begins coping with changes in functional
abilities and body image.
9
These events usher in
the onset of a transition. Two additional features of
transitions are that the process occurs over time
and involves changes in identities, roles, and be-
haviors.
10
The purpose of this article is to describe
psychosocial experiences during the first month
transition period.
Several studies using qualitative methods have
reported on transition processes.
11–13
Findings in-
dicate that the occurrence of a stroke affects the
lives of other family members and the transition
process is chaotic, resulting in changes in family
relationships, caregivers coping with exhaustion,
and survivors taking one day at a time and strug-
gling to hang onto hope for recovery. The chaotic
period is followed by reorganization during which
life becomes more predictable and less stressful.
13
Our study attempts to fill in a portion of the re-
Background: Little is known about the transition experiences of stroke survivors after discharge home. Purpose: The
purpose of this article is to describe three domains of psychosocial experiences of stroke survivors during the first month
following discharge for acute stroke. Method: Data were collected from 125 stroke survivors interviewed at 1 month
following discharge home. Results: Findings indicate that changes in sense of self, connectedness with others, and
community integration presented the major challenges. Key words: psychosocial, stroke, transition