Mangset Margrete, Førde Reidun, Wyller Torgeir Bruun
University of Oslo, Department of Geriatric Medicine, Oslo, Norway.
Clin Rehabil. 2008 Sep;22(9):825-35. doi: 10.1177/0269215508091872.
To identify factors contributing to elderly stroke patients' satisfaction with rehabilitation following stroke.
Qualitative study using semi-structured interviews.
Interviews conducted in two phases, once in a stroke rehabilitation unit and once after hospital discharge.
Twelve elderly stroke patients (seven women and five men, aged 60-87 years).
One main category: 'To be treated with respect and dignity' was identified as a core factor contributing to patients' satisfaction with the rehabilitation services. This main factor was divided into five subcategories: (1) Being treated with humanity, (2) Being acknowledged as individuals, (3) Having their autonomy respected, (4) Having confidence and trust in professionals, (5) Dialogue and exchange of information. The statements covered a continuum from satisfaction via indifference to dissatisfaction. Expressions of satisfaction emerged mainly as general statements while expressions of dissatisfaction described situations in greater detail. Satisfaction was merely connected to daily care experiences and fulfillment of basic needs. Trust in providers and being dignified seemed more closely associated with satisfaction than being involved in treatment decisions. The findings demonstrate how the quality of patient-professional interaction influences patients' satisfaction with stroke rehabilitation.
To be treated with respect and dignity seems to be a core element influencing vulnerable elderly stroke patients' satisfaction with rehabilitation. A merely functional definition of the success of rehabilitation should be expanded into an approach encompassing patients' perceptions and personal preferences. The meaning of dignity for elderly stroke patients in the rehabilitation setting should be further clarified and given practical substance.
确定影响老年中风患者对中风后康复满意度的因素。
采用半结构化访谈的定性研究。
访谈分两个阶段进行，一次在中风康复单元，一次在出院后。
12名老年中风患者（7名女性和5名男性，年龄60 - 87岁）。
确定了一个主要类别：“受到尊重和有尊严的对待”是影响患者对康复服务满意度的核心因素。这个主要因素分为五个子类别：（1）人性化对待；（2）被视为个体；（3）自主权得到尊重；（4）对专业人员有信心和信任；（5）对话和信息交流。这些陈述涵盖了从满意到冷漠再到不满的连续区间。满意的表达主要是一般性陈述，而不满的表达则更详细地描述了具体情况。满意仅仅与日常护理体验和基本需求的满足相关。对提供者的信任和有尊严感似乎比参与治疗决策与满意度的关联更紧密。研究结果表明了患者与专业人员互动的质量如何影响患者对中风康复的满意度。
受到尊重和有尊严的对待似乎是影响脆弱的老年中风患者对康复满意度的核心要素。康复成功的仅仅功能性的定义应扩展为一种包含患者认知和个人偏好的方法。应进一步阐明并赋予康复环境中尊严对老年中风患者的实际意义。
