Introduction: During the post-stroke transitional care phase, dyads consisting of survivors and caregivers face physical, emotional, and informational needs that are often not adequately addressed within a fragmented healthcare system. Although telesupport and teletraining have shown effectiveness, their synchronous application remains largely unexplored. An integrated educational program, facilitated by a nurse navigator, could bridge this gap by providing continuous, personalized support focused on the shared experience of the dyad—an aspect often overlooked in traditional models of care. Aim: To explore the lived experiences of stroke survivor–caregiver dyads who participated in a telesupport and teletraining program during the first month after hospital discharge. Methods: A qualitative study was conducted using a phenomenological design, based on Cohen’s methodological approach. Fourteen dyads were recruited to participate in a structured educational program, which included educational videos, printed informational materials, and weekly remote support provided by a coordinating nurse. One month after discharge, open and in-depth interviews were conducted. Thematic analysis was carried out independently by two researchers, with data triangulation and participant validation to ensure methodological rigor. Results: Two main themes emerged: (1) the Impact of transitional care on dyads, including increased illness awareness, emotional vulnerability, and difficulty resuming daily life; and (2) Satisfied dyadic holistic needs related to telesupport and teletraining delivered, with improved accessibility, psychological well-being, and disability management. The program fostered new dyadic capability. A paradoxical effect also emerged, with the nurse becoming the main source of emotional support, surpassing the family network. Conclusion: Nurse-led telesupport and teletraining seem to be effective in addressing the complex needs of post-stroke survivor–caregiver dyads. The intervention appeared to foster the development of dyadic capability and revealed a paradoxical relational shift, redefining perceived sources of support. These findings suggest the value of integrating telesupport and teletraining into transitional care pathways to support recovery and reduce the psychosocial burden on dyads. As with all qualitative research, these findings are context-specific and not intended to be generalized.
Lombardi et al. (Thu,) studied this question.