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Background: A commonly applied control condition in trials evaluating complex interventions in rehabilitation research is "usual care." The main challenge is to ensure that the control group receives genuine usual care as delivered in everyday clinical practice. The assessment interviews and dialogues with the data collectors may influence the control group participants' reflections on their condition and adjustments. This represents a threat to the internal validity of the trial. Thus, the aim of this study was to explore the perceived study-induced influence of assessment interviews on the adjustment of the members of a control group in a randomized clinical trial. The aim of the trial was to test a dialogue-based psychosocial intervention aiming at promoting the psychosocial well-being and adjustment of stroke survivors., Methods: Fifteen participants in the control group of a multicenter stroke rehabilitation trial participated in narrative semi-structured interviews. Ricoeur's interpretation theory guided the analysis., Results: The perceived study-induced influence of the assessment interviews on the adjustment process of members of the control group varied considerably. The results demonstrated that the assessment interviews facilitated some participants' feelings of control and their ability to cope. Other participants' statements indicate that they relied on their existing personal capacity to cope and adjust and that the assessment interviews did not make any difference either on their coping ability or on their process of adjustment. Five themes were identified that described the perceived study-induced influence of the assessment interviews in the control group. The themes illustrated that the assessments served as a safety net, enhanced awareness and understanding, encouraged seeking support, allowed the opportunity to vent disappointment, or did not make any difference either way., Conclusions: RCT assessment interviews may influence the adjustment process and represent a serious problem in measuring interventions over time in trials of complex interventions in rehabilitation research. To uphold rigor and stringency, the usual care control conditions should be thoroughly assessed and described. Informing participants only about the treatment they were allocated to receive might counteract the potential to dilute the difference between the two arms of the trial., Trial Registration: ClinicalTrials.gov NCT02338869. Registered on October 4, 2014., (© 2021. The Author(s).)

Purpose: This study aims to explore quality of life (QOL) during the first year of recovery after stroke in North Norway and Central Denmark. Method: Individual in-depth interviews with 11 stroke survivors were performed twelve months after stroke onset. An interpretative, inductive approach shaped the interview process and the processing of data. Results: We found that QOL reflected the individuals' reconstruction of the embodied self, which was identified by three intertwined and negotiating processes: a familiar self, an unfamiliar self, and a recovery of self. Further, we found that reconstruction of the embodied self and QOL could be framed as an ongoing and interrelated process of " being, doing, belonging and becoming ". Enriching social relations, successful return to work, and continuity and presence in professional support during recovery enhanced the experience of QOL. Fatigue and sustained reduced function hindered participation in meaningful activities and influenced the perceived QOL negatively. Conclusions: The two countries differed in descriptions of continuity and support in the professional follow-up during the recovery process, influencing the degree of encouragement in reconstructing the embodied self. Reconstruction of the embodied self is a means of understanding stroke survivors' QOL during the first year of recovery, supporting an individualized and tailored rehabilitation practice.

Stroke patients' well-being is threatened after stroke. A psychosocial intervention was developed for Norwegian stroke patients living in the community. Eight individual sessions between people with stroke and a trained health care professional were conducted 1 to 6 months post-stroke with one group of participants and 6 to 12 months post-stroke with another group. Subsequently, 19 of these stroke patients were interviewed to gain an in-depth understanding of their lived experience of the influence of the intervention on their adjustment process. Interview texts were analyzed using Ricoeur's interpretation theory. Two participants did not personally find the intervention useful. The remaining participants greatly appreciated dialogues with the empathetic intervention personnel, feeling free to discuss their fears and worries. The intervention raised these participants' awareness of their needs and resources. They were guided to resume their everyday life and adopt a future-oriented attitude. The intervention facilitated their meaning-making endeavors and post-stroke adjustment.

Rationale: In the last decades, length of stay of in-hospital rehabilitation of patients with stroke has been significantly reduced. Health authorities expect relatives to be at disposal to convey the knowledge of everyday life and to provide emotional as well as practical support in relation to the patient. Caregivers require nurse assistance, support and to be seen as an essential partner in the care giving process. However, the nurses do not perceive that teaching of relatives is a task they should routinely undertake. This might indicate an ambiguity between the relatives' expectations and the actual contribution from nurses., Aim: This study describes nurses' experienced roles and functions addressing the relatives of patients with stroke during in-hospital rehabilitation., Methodological Design: A phenomenological hermeneutic approach influenced by Paul Ricoeur. In a secondary analysis focus group, interviews of 19 randomly selected nurses from three different hospital settings were interpreted in three levels. The study was conducted in accordance with the ethical guidelines for nursing research in the Nordic countries., Findings: The nurses expressed that they address the patient and the relatives and support the interaction between the patient and the relatives. Four themes occurred: the changed lives of relatives; shared life after stroke; noncooperating relatives; time for the relatives., Conclusion: Nurses experience their roles and functions addressing relatives after stroke as crucial, challenging and multifaceted. They acknowledged care needs of the relatives in their own right by addressing the relatives' vulnerability during in-hospital rehabilitation characterised by an existential threat to the physical as well as the shared life. The focus on the needs of relatives considering their expected future role was experienced as conflicting with restricting time frames and a healthcare system focusing on the individual patient., (© 2017 Nordic College of Caring Science.)

Background: The description of nursing roles and functions in rehabilitation of patients with stroke remains sparse., Aim: The aim of this study was to describe the experienced roles and functions of nurses during in-hospital rehabilitation of patients with stroke., Methods: Within a phenomenological hermeneutic approach, 19 nurses working with in-hospital rehabilitation of patients with stroke participated in three focus group interviews during 2013., Findings: The nurses' experiences were described in two themes: (a) the nurse's role and function in relation to the patient's needs 24/7 and (b) the nurse's role and function in the interdisciplinary team. Getting to know the patient as a person was essential to the nurses to care for the patient's basic needs; these must come first working with rehabilitation and always include the relatives. Recognition of the team members' individual skills with focus on the patient's needs must be the center of attention., Conclusion: An interdisciplinary rehabilitation program actively needs to include the patient by integrating the patient's perspective in the goals as well as in daily rehabilitation. In the team, nurses had the role of coordinator and the patient's voice.

Background: There is a paucity of studies, which have described malnutrition in patients with acquired brain injury (ABI) across etiology. This study describes weight change, malnutrition, and potential associations in patients with ABI at a subacute inpatient rehabilitation hospital., Method: This is a descriptive cohort study. Ninety-eight patients were admitted in a 3-month period, of whom n = 76 met inclusion criteria. The Malnutrition Universal Screening Tool was used for categorizing patients according to risk of malnutrition., Results: Patients had experienced weight loss of 5.59% ± 5.89% (p < .001) at admission at the rehabilitation hospital, and patients with traumatic brain injury had experienced a greater weight loss than patients with stroke (p < .01). Thirty percent of patients were at high risk for malnutrition, and 52% of these patients received enteral or parenteral nutrition at admission at the rehabilitation hospital. No association was found between risk of malnutrition and severity of injury, complications, functional outcome, or length of stay., Conclusion: RESULTS underline the importance that nurses, especially in acute care, adhere to clinical guidelines to minimize weight loss. Special attention should be on patients with traumatic brain injury. Weight gain in the following course of rehabilitation may facilitate positive rehabilitation outcomes.

Stroke is a major cause of morbidity and mortality in the world. In the United States, it was estimated that approximately 750,000 patients had a stroke annually. Denmark, with a population of 5.5 million, had about 12,500 cases of hospitalizations from stroke in 2009. Despite the patient's obvious need for complex nursing care and a common recognition of the nurse's central role in rehabilitation after a stroke, a description of their specific contributions appeared sparse. Therefore, a literature review was conducted using the matrix method. The purpose was to explore the nursing roles and functions identified in empirical research and to discern any possible evolution in the nursing roles and functions during a span of years. The rehabilitation literature related to inpatient rehabilitation after stroke during the period from 1997 to 2010 was reviewed. The total number of identified citations was 1,529. After screening for relevancy, 134 eligible articles remained. Of these, 30 articles were extracted into a table and formed the basis for the conclusion. We found that four nursing roles and functions described in 1997 still accommodated central aspects of the current nursing practice but also emerging changes reflecting a development in the nurses' responsibilities and contributions in conducting rehabilitation after a stroke. These changes seemed mainly to be shaped instigated by changes in the (1) patient role, (2) increasing interdisciplinary teamwork, and (3) focus on rehabilitation efforts conducted in the patient's environment.