Satink Ton, Cup Edith H C, de Swart Bert J M, Nijhuis-van der Sanden Maria W G
Department of Occupational Therapy, HAN University of Applied Sciences , Nijmegen , the Netherlands .
Disabil Rehabil. 2015;37(3):223-30. doi: 10.3109/09638288.2014.918187. Epub 2014 May 14.
Self-management has become an important concept in stroke rehabilitation; however, the way that people post-stroke reflect on the concept of self-management has not yet been studied. This qualitative study explored the reflections of persons post-stroke on self-management, readiness and needs in self-management support.
Focus group interviews were conducted with 16 community living stroke survivors (53-84 years of age). Both verbal questions and photo elicitations were used to collect data. A constant comparative framework was used for the analysis.
Participants described their self-management as a complex, long-term, personal learning process. Post-discharge, participants were not ready to self-manage. Aside from individual self-management, participants also mentioned co-management with relatives. Relatives could provide support, but they also limited the development of participants' self-management skills. Participants missed having professional support post-discharge and would have appreciated additional psychological and emotional support in their process of self-management.
Self-management post-stroke is complex. Stroke self-management programmes may be optimised when integrating role and emotional management in addition to medical management. Although readiness to self-manage differs among individuals, support should start as soon as possible and continue post-discharge in people's personal environments. Self-management programmes should not only focus on self-management of stroke survivors but also on co-management with relatives.
自我管理已成为中风康复中的一个重要概念;然而,中风患者对自我管理概念的思考方式尚未得到研究。这项定性研究探讨了中风患者对自我管理、自我管理支持的准备情况和需求的思考。
对16名社区居住的中风幸存者(年龄在53 - 84岁之间)进行了焦点小组访谈。通过口头提问和照片启发两种方式收集数据。采用持续比较框架进行分析。
参与者将他们的自我管理描述为一个复杂、长期的个人学习过程。出院后,参与者还未做好自我管理的准备。除了个人自我管理,参与者还提到了与亲属的共同管理。亲属可以提供支持,但也限制了参与者自我管理技能的发展。参与者出院后怀念专业支持,并且希望在自我管理过程中能得到更多心理和情感上的支持。
中风后的自我管理很复杂。除了医疗管理外,将角色和情绪管理纳入其中,中风自我管理项目可能会得到优化。尽管个体自我管理的准备情况各不相同,但支持应尽早开始,并在出院后在个人生活环境中持续进行。自我管理项目不仅应关注中风幸存者的自我管理,还应关注与亲属的共同管理。