The study aimed to clarify the subjective meaning of independence in walking for hospitalized stroke survivors based on a qualitative analysis.
This study had a cross-sectional design. Interpretative phenomenological analysis was used to investigate the meaning of independence in walking for patients. From 20 patients with subacute stroke recruited by purposeful sampling, 7 who responded that the most important goal of gait training was independence in walking were selected as participants. In interviews, the participants were asked why they think independence in walking is important and they were requested to explain their reasons. NVivo14 was used for qualitative analysis.
The seven stroke survivors (4 men, 3 women) had mean age of 70.1±9.2 years, median time since stroke of 37 days, and median functional ambulatory category of 4. Based on an interpretative phenomenological analysis of the interview data, we found the following three themes.
- “Walking by oneself without worrying about others”: In addition to not being assisted, the patients hoped to walk without needing help from others and without bothering others.
- “Going to familiar places again”: The patients hoped to walk to places they used to go to before their stroke, including shopping centers, workplaces, and places for recreational activities.
- “Walking in my style”: The patients hope to walk again in the same style they used to walk before stroke, which enabled them to engage bodily with their lifeworld.
The identified themes contribute to understanding what independence in walking means for patients with stroke. The meaning of independence was derived from their personal histories and experiences in the lifeworld as well as their relationships with others. In addition, the style of walking of each patient represented the way he or she interacts and copes with the world. This finding goes beyond the meaning of independence that is shared among the therapists based on standard assessment methods. The result may be useful in planning interventions for walking in stroke rehabilitation, taking the patient’s perspective into consideration.
It is important to include both evidence-based and narrative-based practice in rehabilitation. Therefore, when providing gait rehabilitation, therapists may contribute to the development of a shared understanding of the importance of walking from the perspective of patients by conducting regular interviews.
walking independence
rehabilitation
