Barriers and facilitators to implementation of proper limb positioning in hemiplegic stroke patients: a qualitative study

Abstract

Objective: To identify factors that can be targeted to promote the standardized management of proper limb positioning and improve the rehabilitation outcomes of patient. Method: A qualitative descriptive study was conducted using semi-structured face-to-face in-depth interviews with 24 clinical nurses working in stroke-related departments between April and May 2024. Based on the COM-B model, the data were analyzed by employing the deductive content analysis method using the NVivo12 software and manual coding. Results: Analysis revealed 11 themes and 22 sub-themes associated with the four domains of the COM-B model, including 15 barriers and 7 facilitators. Conclusion: Clinical nurses' adherence to proper limb positioning is dynamic and positioning should address barriers related to capability, opportunity, and motivation, such as prioritize knowledge and skills training for clinical nurses, improved compliance among patients and caregivers, establish robust systems and supervisory mechanisms, and support scientific research and innovation to explore intelligent management solutions.