Challenges and Opportunities in Cognitive Rehabilitation Services: Perspectives from Rehabilitation Professionals

Objective: This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment (PSCI) in China, offering empirical evidence for optimizing service models. Methods: Using purposive sampling, semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023. Audio recordings were transcribed to obtain textual data, which were analyzed using Nvivo 12 software for coding. An inductive thematic analysis approach was employed to distill key themes. Results: The study identified multiple facilitating and hindering factors related to cognitive rehabilitation, summarizing them into four core themes and eight sub-themes: (1) Cognitive Screening: Presence of practical barriers and inadequate professional knowledge, which limited early detection and effective intervention for cognitive impairments; (2) Individualized Rehabilitation: Lack of patient -directed personalized interventions and multidisciplinary team collaboration, affecting patient engagement and rehabilitation outcomes; (3) Lack of Psychological Rehabilitation: The necessity of psychological interventions was emphasized, yet there is a significant scarcity of neuropsychological resources, limiting the implementation of psychological support; (4) Challenges of Community Continuity in Rehabilitation: Severe service discontinuity, with community healthcare institutions facing shortages of professional knowledge and equipment, resulting in patients being unable to receive continuous and effective rehabilitation support after discharge. Conclusion: Current PSCI rehabilitation services face issues such as insufficient staffing, ineffective multidisciplinary team collaboration, and a lack of community resources. Enhancing neuropsychological resources, establishing standardized MDT collaboration processes, and creating a referral system linking hospitals, communities, and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.