Young stroke survivors’ experiences and approaches to community reintegration: a descriptive qualitative study

Community reintegration is a key goal for younger survivors of stroke due to participation demands such as returning to work and caring for dependents. However, current post-stroke rehabilitation services largely cater to older survivors and lack targeted support to promote reengagement in life activities. This study aimed to explore the community participation experiences of young stroke survivors to better understand their recovery needs and provide insight into strategies to enhance community reintegration and post-stroke care services. A qualitative descriptive study was carried out. Twenty-one stroke survivors aged between 18 and 64 years were recruited from a community-based rehabilitation centre and stroke support group in Hong Kong. Individual semi-structured interviews were conducted to explore participants’ experiences of post-stroke community participation, associated facilitators and barriers, unmet health needs, and required support. Interview data were thematically analysed. Participants were aged 55.5 (SD: 7.0) years on average, and had stroke for a mean of 8.1 years (SD: 6.5). Four main themes were identified: (1) self-expectations and personal drive to recover; (2) physical, psychosocial, and environmental obstacles; (3) personal strategies to overcome barriers; and (4) external facilitators and recovery needs. Overall, while survivors were motivated and expressed a keen desire to resume life engagement by taking up former responsibilities and activities, factors such as limited functional mobility, lack of age-appropriate rehabilitation services, and insufficient social and vocational support were notable barriers to participation. This study demonstrated that the resumption of community participation was a significant concern for younger stroke survivors, indicating that diversified stroke rehabilitation and support services are required to meet their age-based recovery demands. Return to work may be supported by timely vocational rehabilitation and promoting disability-friendly workplace policies, while volunteering opportunities could be provided as an alternative vocational activity. Furthermore, educational and psychosocial interventions to promote positive interpersonal relationships and strengthen survivors’ mental health would be helpful in facilitating participation outcomes.