The experiences of stroke survivors with eating and drinking difficulties, in acute stroke units: a qualitative inquiry

To examine the eating and drinking difficulties of stroke survivors in acute stroke units, aiming to identify challenges and opportunities to enhance current rehabilitation practices within stroke care. This qualitative, multi-method study explored stroke survivors’ experiences. Data collection included six hours of observations in two UK stroke wards, five stroke survivor interviews, and one informal carer interview. Filmed interviews were also conducted with two stroke survivors, one informal carer, and five healthcare staff. Participants for the interviews were selected <i>via</i> purposive sampling. Thematic analysis followed Thomas and Harden’s three-step method for detailed data exploration. Stroke survivors faced significant challenges with eating and drinking, including isolation, inadequate assistance, limited adaptive equipment, and restricted communal dining. Stroke survivors reported embarrassment and frustration over physical limitations. Both survivors and staff emphasised the importance of social connections during meals, advocating for shared dining to improve well-being. Greater personalisation and culturally informed menu options were suggested to better meet patients’ diverse needs and enhance mealtime experiences. Utilising communal ward environments to foster social interaction, offering individualised support, and utilising adaptive equipment may address eating and drinking challenges and may improve the psychological and social well-being of stroke survivors. Incorporating therapeutic mealtime experiences, such as shared meals in group settings, could promote psychological well-being, foster a sense of normalcy, and encourage patients’ active involvement in daily activities.Ensuring the consistent availability of adaptive equipment and normalising the use of specialised eating aids, along with providing staff training to support their application, could enhance patient autonomy and participation during mealtimes.Rehabilitation programs could prioritise environments and interventions that encourage peer interaction, facilitate skill-building, and promote a sense of accomplishment.Structured opportunities for patients to observe and learn from others, as well as tailored strategies that empower them to regain a sense of control, could play a pivotal role in their recovery of eating and drinking skills.The findings of this study emphasise the need to address the diverse needs of patients through better personalisation and culturally informed menu options, which could significantly enhance their mealtime experience. Incorporating therapeutic mealtime experiences, such as shared meals in group settings, could promote psychological well-being, foster a sense of normalcy, and encourage patients’ active involvement in daily activities. Ensuring the consistent availability of adaptive equipment and normalising the use of specialised eating aids, along with providing staff training to support their application, could enhance patient autonomy and participation during mealtimes. Rehabilitation programs could prioritise environments and interventions that encourage peer interaction, facilitate skill-building, and promote a sense of accomplishment. Structured opportunities for patients to observe and learn from others, as well as tailored strategies that empower them to regain a sense of control, could play a pivotal role in their recovery of eating and drinking skills. The findings of this study emphasise the need to address the diverse needs of patients through better personalisation and culturally informed menu options, which could significantly enhance their mealtime experience.

本研究旨在调查急性卒中病房（acute stroke units）内卒中幸存者（stroke survivors）的进食与饮水困难，以期识别当前卒中护理康复实践中存在的挑战与优化机遇。本项质性多方法研究探索了卒中幸存者的相关体验。数据采集涵盖在英国两家卒中病房开展的6小时现场观察、5次卒中幸存者访谈以及1次非正式陪护人员访谈。此外，还对2名卒中幸存者、1名非正式陪护人员及5名医护人员开展了录像访谈。访谈参与者通过<i>via</i>目的性抽样（purposive sampling）法选取。研究采用Thomas与Harden提出的三步法开展主题分析（thematic analysis），以进行细致的数据探索。
卒中幸存者在进食与饮水方面面临诸多显著挑战，包括社交孤立、辅助支持不足、适配辅助器具（adaptive equipment）匮乏以及公共用餐空间受限。卒中幸存者坦言，自身肢体功能受限令其感到窘迫与挫败。幸存者与医护人员均强调用餐期间社交联结的重要性，倡导通过共享用餐提升患者福祉。研究建议通过提供更多个性化服务与符合文化背景的餐食选项，更好地满足患者多样化需求，优化用餐体验。
利用病房公共空间促进社交互动、提供个性化支持及合理使用适配辅助器具，或可解决卒中幸存者的进食与饮水困难，同时改善其心理与社会福祉。融入治疗性用餐体验，例如小组共享用餐，可促进患者心理健康、营造正常生活感，并鼓励患者积极参与日常活动。确保适配辅助器具的持续供应、推广专用进食辅助器具（specialised eating aids）的使用，同时为医护人员提供相关应用培训，可提升患者在用餐期间的自主性与参与度。康复项目可优先打造鼓励同伴互动、助力技能提升并增强成就感的环境与干预方案。为患者提供结构化的观察学习机会，以及赋予其掌控感的定制化策略，或可在其进食与饮水技能康复中发挥关键作用。
本研究结果强调，需通过优化个性化服务与符合文化背景的餐食选项，满足患者多样化需求，从而显著改善其用餐体验。融入治疗性用餐体验，例如小组共享用餐，可促进患者心理健康、营造正常生活感，并鼓励患者积极参与日常活动。确保适配辅助器具的持续供应、推广专用进食辅助器具的使用，同时为医护人员提供相关应用培训，可提升患者在用餐期间的自主性与参与度。康复项目可优先打造鼓励同伴互动、助力技能提升并增强成就感的环境与干预方案。为患者提供结构化的观察学习机会，以及赋予其掌控感的定制化策略，或可在其进食与饮水技能康复中发挥关键作用。本研究结果再次强调，需通过优化个性化服务与符合文化背景的餐食选项，满足患者多样化需求，从而显著改善其用餐体验。