Dixon Guy, Thornton Everard W, Young Carolyn A
University of Liverpool; Walton Centre for Neurology and Neurosurgery, Liverpool, Liverpool, UK.
Clin Rehabil. 2007 Mar;21(3):230-40. doi: 10.1177/0269215506071784.
To explore constructs relevant to self-efficacy in neurological rehabilitation.
Qualitative methods using semi-structured interviews.
Specialist neurological rehabilitation unit, Liverpool, UK.
Twenty-four patients (12 male) with experience of inpatient rehabilitation, aged 17-59 (mean 38.1) years at onset, with diagnoses of stroke (n = 8), traumatic brain injury (n = 6) or other monophasic neurological impairment (n = 10).
Eleven themes emerged from the data that reflect self-efficacy beliefs: self-reliance and independence were deemed important and many patients recognized the importance of determination, making time to take an active role and working in partnership with the multidisciplinary team. Patients had complex information needs but were able to use goal setting and the vicarious experiences of other inpatients to map out the stages of their own recovery. It was important for patients to be able to recognize for themselves that they were making progress and they valued external reassurance on this from other patients, staff and visitors. A number of difficulties were identified that interfered with their developing self-efficacy in rehabilitation, such as structuring their time. Two different models for rehabilitation emerged from the data, 'recovery' and 'adaptation'.
Patients consistently identified 11 factors falling in the supraordinate themes of self, others and process, and these influenced their self-efficacy to participate in neurological rehabilitation. Patients consider rehabilitation in terms of either an 'adaptation' or 'recovery' model.
探讨神经康复中与自我效能相关的概念。
采用半结构化访谈的定性研究方法。
英国利物浦的专业神经康复单元。
24例有住院康复经历的患者（男性12例），发病时年龄17 - 59岁（平均38.1岁），诊断为中风（n = 8）、创伤性脑损伤（n = 6）或其他单相神经功能障碍（n = 10）。
数据中出现了11个反映自我效能信念的主题：自力更生和独立被认为很重要，许多患者认识到决心、积极主动投入时间以及与多学科团队合作的重要性。患者有复杂的信息需求，但能够利用目标设定和其他住院患者的替代经验来规划自己的康复阶段。患者能够自己认识到自己在进步很重要，他们重视来自其他患者、工作人员和访客的外部肯定。还发现了一些阻碍他们在康复中发展自我效能的困难，比如安排时间。数据中出现了两种不同的康复模式，即“恢复”和“适应”。
患者一致确定了11个属于自我、他人和过程等上位主题的因素，这些因素影响了他们参与神经康复的自我效能。患者从“适应”或“恢复”模式的角度来考虑康复。
