Using an interview study of transport use by people who have had a stroke to inform rehabilitation.

INTRODUCTION: Many people who have had a stroke want to get out of their house more often. This study explored attitudes and barriers to the use of transport with the aim of informing rehabilitation.
METHOD: Semi-structured interview study of 24 community-dwelling people who had had a stroke, purposively sampled to find people with a variety of recent experiences of transport. Interviews were taped and transcribed. Analysis was by constant-comparative methodology, to develop emerging themes and concepts.
RESULTS: Interviewees wanted to travel for specific purposes but also for its own sake. Many could no longer use their car. This gave them less flexibility to travel and reduced their autonomy. Barriers to using alternative forms of transport were fear of injury or embarrassment from falling, an associated lack of confidence, inadequate information about transport services, perceptions about the cost of taxis and pavement vehicles (scooters) and environmental factors such as the weather. Those who could drive, or who lived with someone who did, gave the most positive descriptions of transport use. Those reliant on family or friends felt they could ask only for help getting to health-related appointments and those who used specialist transport services provided the most negative descriptions of transport.
CONCLUSIONS: Many of the barriers to transport use after stroke may be amenable to intervention. An intervention package capable of re-enabling people to drive or be driven, to use a pavement scooter safely, to provide information about the alternatives and to encourage best use of public transport is worth developing.