Title: A change perspective on the rehabilitation of people with apoplexy – a person-centered approach

Background: Every year, approximately 20,000 people in Denmark are affected by apoplexy, and a total of 170,000 live with the consequences of this. Even though people with apoplexy have differentiated needs and express a desire for autonomy in rehabilitation, involvement is not a focal point of the National Clinical Guidelines and Recommendations for cross-sectoral courses for adults with acquired brain injury. Thus, a public health problem is seen, as the Danish Health Authority's structural measures aimed at people with apoplexy do not contain the complexity and need for a person-centered approach but are generalized across all persons and contexts.

Purpose: The purpose of the thesis is to develop change perspectives that will contribute to a person-centered municipal rehabilitation for people with apoplexy.

Method: The thesis is based on critical realism, and the development of the change perspectives is based on the MRC-framework. The change perspectives are developed on the basis of empirical evidence and a theoretical frame of reference. A systematic literature review has been carried out in the thesis, the purpose of which was to investigate what knowledge exists about person-centered rehabilitation for people with apoplexy in the municipal context. In addition, realistic interviews have been conducted with eight people with apoplexy who were in the process of a §140 rehabilitation, as well as any relatives, in order to gain insight into the apoplexy sufferers' perspective on what factors have an impact on the rehabilitation process. In addition, an informal meeting with practice was held, where the thesis group gained insight into the municipal rehabilitation. The results from the above methods, combined with Brendan McCormack's theory of person-centeredness, have been used to develop the thesis's change perspectives.

Results: Based on the results, five change perspectives have been developed, which aim to contribute to a person-centered municipal rehabilitation for people with apoplexy. The five change perspectives are: Focus on collaboration and coordination internally and externally; Flexibility in the organization of rehabilitation; Focus on the relationship between the therapist, the apoplexy sufferer and possibly relatives; Focus on the development of therapists' professional expertise; Focus on social communities among people with apoplexy.

Conclusion: The change perspectives can contribute to a person-centered municipal rehabilitation for people with apoplexy. However, in the further development of the change perspectives, it is necessary to take into account the context in which the change perspectives are to be implemented, including e.g. the political and economic framework management that has an impact on the change perspectives.