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参与中风后以客户为中心的日常生活活动干预的体验。

Experiences of participating in a client-centred ADL intervention after stroke.

机构信息

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Disabil Rehabil. 2019 Dec;41(25):3025-3033. doi: 10.1080/09638288.2018.1483434. Epub 2018 Jul 1.

Abstract

This qualitative study was conducted in the context of a client-centred activities of daily living (CADL) intervention aiming to enable agency in daily activities and participation in everyday life after stroke. The intervention was based on the principles of client-centred occupational therapy and then further developed based on empirical research findings. To identify what from the clients' perspective characterises the lived experience and meaning of participating in a CADL intervention after stroke. The study included 10 persons with stroke who received the intervention and who were able to communicate their experience of participating. Data were collected through two interviews, after the initiation and after the end of the intervention. The analysis was performed using an empirical phenomenological psychological method. The overall characteristic of the meaning of participating in the intervention was transparency, which was expressed in the participants' experiences of being able to see and follow their own rehabilitation process. An awareness and understanding of their own situation enabled the participants to be actively involved in their rehabilitation. The intervention contributed to transparency, which appeared to enable and support the client's sense of ownership of daily activities and rehabilitation after stroke.Implications for rehabiliationA client-centred activities of daily living intervention seems to contribute to transparency, where persons with stroke can discover and understand their new ability and situation after stroke.A client-centred rehabilitation situation seems to enable clients to actively engage in their own rehabilitation process.Inviting clients to participate in goal-setting seems to be important in order to create the experience of transparency.Creating continuity in the therapeutic alliance seems to be important in order for the clients to feel trust and experience agency in everyday life.

摘要

本定性研究是在以客户为中心的日常生活活动(CADL)干预的背景下进行的,旨在使中风后日常生活中的自主活动和参与成为可能。该干预措施基于以客户为中心的职业治疗原则,并根据实证研究结果进一步发展。确定从客户的角度来看,参与中风后 CADL 干预的特点是什么,以及日常生活的体验和意义。研究包括 10 名接受过干预且能够交流参与经验的中风患者。数据通过两次访谈收集,一次在干预开始后,一次在干预结束后。分析采用经验现象学心理学方法进行。参与干预的总体意义特征是透明性,这表现在参与者能够看到和跟踪自己康复过程的体验中。对自己情况的认识和理解使参与者能够积极参与自己的康复。干预措施有助于提高透明度,这似乎使客户对中风后日常生活和康复的自主权产生了积极的影响。对康复的启示以客户为中心的日常生活活动干预似乎有助于提高透明度,使中风患者能够发现和理解中风后的新能力和新情况。以客户为中心的康复环境似乎使客户能够积极参与自己的康复过程。邀请客户参与目标设定似乎很重要,以便创造透明的体验。在治疗联盟中保持连续性似乎很重要,以使客户感到信任并在日常生活中体验自主权。

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