Adherence to a Rehabilitation Regimen in Stroke Patients: A Concept Analysis

Maryam Khoshbakht Pishkhani, Asghar Dalvandi, Abbas Ebadi, Mohammad Ali Hosseini


Background: Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients.

Materials and Methods: This qualitative concept analysis was performed using Walker and Avant’s method. English and Persian articles were searched using keywords such as “adherence”, “compliance”, “rehabilitation”, “stroke”, and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study.

Results: The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient‑related and environmental‑related categories and the consequences were classified into the three categories of patient‑related, healthcare professional‑related, and healthcare system‑related.

Conclusions: This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.


Iran, patient compliance, rehabilitation, stroke

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