Balakrishnan Revathi, Kaplan Benjamin, Negron Rennie, Fei Kezhen, Goldfinger Judith Z, Horowitz Carol R
Division of Cardiology, New York University School of Medicine, 462 1st Avenue NBV 17S5, New York, NY 10016, USA.
University of North Carolina School of Medicine, 321 S Columbia St, Chapel Hill, NC 27516, USA.
Int J Environ Res Public Health. 2017 Mar 11;14(3):293. doi: 10.3390/ijerph14030293.
Stroke is a leading cause of disability in the United States and disproportionately affects minority populations. We sought to explore the quality of life in urban, minority stroke survivors through their own photos and narratives. Using the Photovoice method, seventeen stroke survivors were instructed to take pictures reflecting their experience living with and recovering from stroke. Key photographs were discussed in detail; participants brainstormed ways to improve their lives and presented their work in clinical and community sites. Group discussions were recorded, transcribed, and coded transcripts were reviewed with written narratives to identify themes. Participants conveyed recovery from stroke in three stages: learning to navigate the initial physical and emotional impact of the stroke; coping with newfound physical and emotional barriers; and long-term adaptation to physical impairment and/or chronic disease. Participants navigated this stage-based model to varying degrees of success and identified barriers and facilitators to this process. Barriers included limited access for disabled and limited healthy food choices unique to the urban setting; facilitators included presence of social support and community engagement. Using Photovoice, diverse stroke survivors were able to identify common challenges in adapting to life after stroke and important factors for recovery of quality of life.
中风是美国导致残疾的主要原因，且对少数族裔人口的影响尤为严重。我们试图通过城市少数族裔中风幸存者自己拍摄的照片和讲述的故事来探究他们的生活质量。采用摄影之声方法，指导17名中风幸存者拍摄反映他们中风后生活及康复经历的照片。对关键照片进行了详细讨论；参与者集思广益，探讨改善生活的方法，并在临床和社区场所展示他们的作品。对小组讨论进行了录音、转录，并将编码后的转录文本与书面叙述一起进行审查，以确定主题。参与者描述了中风康复的三个阶段：学会应对中风最初的身体和情感影响；应对新出现的身体和情感障碍；长期适应身体损伤和/或慢性病。参与者在不同程度上成功地遵循了这个基于阶段的模式，并确定了这一过程中的障碍和促进因素。障碍包括残疾人的机会有限以及城市环境中特有的健康食品选择有限；促进因素包括社会支持的存在和社区参与。通过摄影之声，不同的中风幸存者能够识别出中风后适应生活的共同挑战以及生活质量恢复的重要因素。
