White Carole L, Barrientos Rosalinda, Dunn Kelly
Questions or comments about this article may be directed to Carole L. White, PhD RN, at
J Neurosci Nurs. 2014 Aug;46(4):233-40. doi: 10.1097/JNN.0000000000000066.
There has been limited examination of uncertainty after stroke. The effects of stroke extend beyond the stroke survivor to impact on the family, and thus, an exploration of uncertainty with the stroke survivor-caregiver dyad is important to gain a fuller understanding.
Stroke survivors and their family caregivers (n = 33) participated in eight focus groups. Transcripts from the focus groups were examined for recurrent themes using content analysis. Mishel's theory of uncertainty was used as a framework to classify the themes.
Participants reported uncertainty about (a) future events, in particular, recurrent stroke; (b) signs and symptoms of stroke; (c) stroke risk factor management; and (d) resources for poststroke care. The uncertainty was brought on by the lack of predictability of these future events, lack of information, and the complexity of poststroke care and corresponded to Mishel's four key elements of ambiguity, deficient information, lack of clarity, and unpredictability.
The fear of recurrent stroke was a pervasive theme and may represent a window of opportunity to work actively with stroke survivors in managing their risk factors. Although certain aspects of uncertainty after stroke cannot be eliminated, we can intervene with stroke survivors and family caregivers to assist them in reframing their responses to uncertainty and to foster coping and promote health.
对中风后不确定性的研究有限。中风的影响不仅限于中风幸存者，还会波及家庭，因此，探讨中风幸存者与照顾者二元组的不确定性对于更全面的理解至关重要。
中风幸存者及其家庭照顾者（n = 33）参与了八个焦点小组。使用内容分析法检查焦点小组的记录，以找出反复出现的主题。米歇尔的不确定性理论被用作对主题进行分类的框架。
参与者报告了对以下方面的不确定性：（a）未来事件，特别是中风复发；（b）中风的体征和症状；（c）中风危险因素的管理；（d）中风后护理资源。这些不确定性是由这些未来事件缺乏可预测性、信息不足以及中风后护理的复杂性导致的，与米歇尔的模糊性、信息不足、缺乏清晰度和不可预测性这四个关键要素相对应。
对中风复发的恐惧是一个普遍存在的主题，可能代表了一个与中风幸存者积极合作管理其危险因素的机会窗口。尽管中风后不确定性的某些方面无法消除，但我们可以对中风幸存者及其家庭照顾者进行干预，帮助他们重新构建对不确定性的反应，促进应对并增进健康。
