J Rehabil Med 46
ORIGINAL REPORT
J Rehabil Med 2014; 46: 858–863
© 2014 The Authors. doi: 10.2340/16501977-1854
Journal Compilation © 2014 Foundation of Rehabilitation Information. ISSN 1650-1977
Objective: To explore stroke survivors’, caregivers’, and
health care professionals’ perceptions of weekend passes of-
fered during inpatient rehabilitation and its role in facilitat-
ing the transition home.
Design: Qualitative descriptive.
Subjects: Sixteen stroke survivors, 15 caregivers, and 20
health care professionals’ from a rehabilitation hospital.
Methods: Participants discussed their perceptions of the pur-
pose of the weekend pass, experiences with the weekend pass
including supports needed, and weekend pass administra-
tion. Focus group and interview data were audio recorded,
professionally transcribed, checked for accuracy, and ana-
lyzed using conventional content analysis.
Results: We identified 3 key themes: i) preparing for patients
to be safe at home; ii) gaining insight through the weekend
pass; and iii) the emotional context of the weekend pass.
These themes varied by participant group.
Conclusions: When offering weekend passes, stroke care
systems should carefully consider patients’ and caregivers’
readiness, emotional state, and preparation for weekend
passes. The weekend pass experience can inform in-patient
therapy, provide patients and caregivers with insight into
life after stroke, and help prepare patients and families for
the ultimate transition home.
Key words: stroke; rehabilitation; caregiver; transitions; health
care professionals; health service delivery; qualitative.
J Rehabil Med 2014; 46: 858–863
Correspondence address: Jill Cameron, Department of Oc-
cupational Science and Occupational Therapy, University
of Toronto, 160-500 University Ave., Toronto, ON M5G 1V7,
Canada. E-mail: jill.cameron@utoronto.ca
Accepted Apr 17, 2014; Epub ahead of print Aug 28, 2014
INTRODUCTION
Individuals who experience a stroke utilize many elements
of the health care system including emergency department,
acute hospital, inpatient rehabilitation, community, and long-
term care services. Unfortunately, these elements tend to lack
a common coordinating system (1) and stroke survivors and
family caregivers are often left to manage their movement
across these diverse care environments (2). Patients and their
caregivers suggest the transition home is the most challenging
(3, 4). Many stroke survivors and caregivers feel anxiety, a lack
of preparedness, and a sense of abandonment as they return to
the community (5, 6). Strategies to improve the transition home
would not only benefit stroke survivors and their caregivers but
could also reduce hospital readmissions, home care demands,
and overall health care costs (7).
Since the early 1970s, weekend passes (WPs) have been rec-
ommended as a method to facilitate stroke survivors’ transition
home (8). A WP typically entails stroke survivors going home
under the supervision of their family from Friday to Sunday
evening. For many health care organizations, WPs have become
standard practice, but we were not able to identify any research
examining their impact on the transition home, or on stroke
survivors’, family caregivers’ or health care professionals’
(HCPs) experiences with them.
The objective of our research was to obtain an in-depth
understanding of patients’, family caregivers’, and HCPs’ per-
ception of WPs and its role in facilitating the transition home.
METHODS
Study design
A qualitative descriptive approach was used to obtain a rich and in-
depth account of participants’ perspectives on the WP and to develop
a data-near report (9–11).
Recruitment and sample
The research was conducted at a rehabilitation facility in a large urban
center where WPs are a standard element of their in-patient program. The
study protocol was approved by the University’s and rehabilitation facil-
ity’s research ethics boards. Members of the research team approached,
recruited, and interviewed consecutive patients and caregivers during the
week following the first WP. Second interviews took place approximately
4 weeks after patients had been fully discharged home. HCPs affiliated
with the stroke team were invited to participate in one of 3 focus groups
or an in-depth interview. All participants provided written consent.
STROKE SURVIVORS’, CAREGIVERS’, AND HEALTH CARE
PROFESSIONALS’ PERSPECTIVES ON THE WEEKEND PASS TO FACILITATE
TRANSITION HOME
Jill I. Cameron, PhD
1,2,5
, Marina Bastawrous, MSc
2
, Amanda Marsella, MSc, Samantha Forde,
MScOT
1
, Leslie Smale, MScOT
1
, Judith Friedland, PhD
1,2
, Denyse Richardson, MD
3,5
and
Gary Naglie, MD
3,4,5,6
From the
1
Department of Occupational Science and Occupational Therapy,
2
Graduate Department of Rehabilitation
Science,
3
Department of Medicine, and
4
Institute of Health Policy, Management and Evaluation, University of Toronto,
5
Department of Research, UHN – Toronto Rehabilitation Institute and
6
Department of Medicine and Rotman Research
Institute, Baycrest Health Sciences, Toronto, Canada