Wael Alghamdi Nursing Faculty, Al-Baha University, Al-Baha, Saudi ArabiaCorrespondence: Wael Alghamdi, Faculty of Nursing, Al-Baha University, Al-Baha, Saudi Arabia, Email waelalghamdi@bu.edu.saPurpose: To explore how Saudi men interpret pelvic floor-related symptoms and perceive pelvic floor muscle training (PFMT), and to identify barriers and facilitators influencing help-seeking and engagement with conservative rehabilitation support.Materials and methods: This qualitative explanatory follow-up study was conducted in Al-Baha, Saudi Arabia, with 19 Saudi men recruited from a previous PFMT knowledge, attitudes, and practices study. One-to-one semi-structured interviews were conducted in Arabic, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis.Results: Four interrelated themes were generated: normalizing or minimizing symptoms; awareness of PFMT without practical understanding; embarrassment and privacy as central barriers; and trust, explanation, and professional support, including physiotherapy, as conditions for potential engagement with PFMT.Conclusion: Limited practical understanding of PFMT, embarrassment, delayed help-seeking, and lack of trusted guidance helped explain why awareness did not translate into practice. Male-sensitive education, practical skills training, privacy-conscious communication, and follow-up may support men’s engagement with physiotherapy-led conservative pelvic health care.Keywords: Pelvic floor muscle training, physiotherapy, rehabilitation, help-seeking, qualitative research, Saudi Arabia
Kyoungyee Kang,1 Junesung Lee,1 Ji Won Lee,1 Chang-Yoon Baek,1,2 Dong kyu Kim,1 Jeon Wook Kwon,1 Jae Young Choi,1 Yelim An,1 Joo Youn Kim,3 Hyunsun Lim,3 Woo-Ri Lee,4 Myeonghwan Bang1 1Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea; 2Graduate School of Sports Medicine, CHA University, Pocheon, Republic of Korea; 3Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea; 4Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of KoreaCorrespondence: Myeonghwan Bang, Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Goyang, 10444, Republic of Korea, Tel +82-10-6244-0252, Email relight0222@gmail.comBackground: Multidisciplinary rehabilitation and structured goal setting are strongly recommended in subacute stroke care. However, in clinical practice, regular multidisciplinary goal-setting approaches have not been consistently implemented because of time and logistical constraints.Objective: To develop a structured multidisciplinary goal-setting framework for subacute stroke rehabilitation through a single-center expert consensus process.Methods: A multidisciplinary inpatient rehabilitation framework was developed through a targeted literature review and structured expert consensus meetings. A 12-member multidisciplinary panel held 10 face-to-face meetings at 2-week intervals to define the rehabilitation domains, workflow structure, and implementation strategy. Components were adopted through iterative multidisciplinary discussion until agreement was reached. No formal voting was conducted, and no quantitative consensus threshold was prespecified.Results: The final framework comprised three phases: admission, weekly inpatient cycles, and discharge. It integrated domain-specific assessments and problem lists, with structured inpatient and weekly goals based on the specific, measurable, achievable, relevant, and timed criteria. In the framework, goal attainment is evaluated using goal attainment scaling, supported by weekly progress documentation. An electronic medical record-based asynchronous communication model was proposed for future implementation to support multidisciplinary coordination.Conclusion: This framework was designed to support structured weekly multidisciplinary goal setting after subacute stroke. Its feasibility, usability, and effects on clinical outcomes have not been evaluated, and prospective multicenter validation is required.Keywords: stroke rehabilitation, multidisciplinary care, patient care team, goals, goal attainment scaling, clinical framework
Zeyue Sun, Di Chen, Wenqian Huang, Yan Song, Shanshan Jiang, Xujia Zhai, Tao Liu, Wei Zhu Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Wei Zhu, Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing, Jiangsu, People’s Republic of China, Email zhuwei625@163.comPurpose: To examine how adults aged 65 years or older and their primary caregivers interpreted and intended to act on discharge red-flag instructions after intracranial aneurysm treatment, explore neurosurgical nurses’ perspectives on recurrent discharge communication problems, and iteratively refine the instructions for safer transitional care.Patients and methods: This single-center qualitative study used cognitive interviewing in a tertiary neurosurgical unit in China. Twenty-four older patients and 20 primary caregivers completed cognitive interviews across two iterative rounds; eight neurosurgical nurses completed separate contextual interviews. Think-aloud and verbal probing assessed comprehension and intended action. Framework Method analysis of round 1 informed revisions tested with new participants in round 2.Results: Four high-risk communication problems were identified: under-recognition of gradual neurological deterioration, ambiguity created by clinical wording, difficulty mapping symptoms to escalation pathways, and patient–caregiver disagreement about action. Subtle signs, including progressive drowsiness, mild speech change, repeated vomiting, and incomplete limb weakness, were often normalized. Revisions used observable symptom descriptions, explicit action cues, and caregiver-directed prompts. Round 2 suggested fewer recurring comprehension problems and closer alignment between intended responses and clinical intent, although blood pressure guidance remained challenging for some participants.Conclusion: Standard red-flag instructions may not be sufficiently actionable for older adults and caregivers after intracranial aneurysm treatment. Cognitive interviewing can support clearer, caregiver-inclusive discharge tools reinforced by nurse-led teach-back.Plain Language Summary: After treatment for a brain aneurysm, older people and their families must know which changes can be watched at home and which require urgent help. We asked older patients and their primary caregivers to explain routine warning-sign instructions in their own words and describe what they would do. Nurses who routinely provided discharge teaching were also interviewed. Participants usually recognized dramatic emergencies, but subtle changes—such as becoming progressively sleepier, speaking more slowly, vomiting repeatedly, or developing partial weakness—were often mistaken for normal recovery or aging. We revised the instructions by using observable descriptions, pairing each warning sign with a clear action, and speaking directly to caregivers. A second round of interviews indicated that the revised instructions were easier to interpret, although blood pressure advice still caused uncertainty. These findings support a short action sheet and nurse-led teach-back as practical ways to make discharge communication safer. The study assessed understanding and intended action; it did not test whether the revised material reduces emergency visits, delayed care, or readmission.Keywords: cognitive interviewing, discharge communication, intracranial aneurysm, older adults, caregivers, transitional care
