Bailey Ryan
Brown School, Washington University in St. Louis, St. Louis, MO, USA.
Disabil Rehabil. 2020 Sep;42(18):2631-2639. doi: 10.1080/09638288.2019.1568591. Epub 2019 Apr 11.
A better understanding of psychosocial factors underlying daily physical activity (i.e. physical activity performed throughout the day) in stroke survivors could be used to develop interventions to promote post-stroke physical activity, particularly in individuals for whom exercise is difficult. In-depth qualitative interviews were conducted with 15 ambulatory, community-dwelling stroke survivors. Interview transcripts were analyzed using directed content analysis, guided by Social Cognitive Theory, to investigate outcomes expectations, self-efficacy, self-regulation, and social-support for daily physical activity. Participants reported that physical and mental health, and independence and recovery, were important outcomes expectations. Self-efficacy was enhanced through mental perceptions and mastery experiences. Planning, problem-solving, reviewing performance, and establishing routines that require physical activity were important self-regulation strategies. Social support provided praise and encouragement and physical assistance, but was also a barrier when friends and family were overprotective. Participants reported that the investigated Social Cognitive Theory constructs were important psychosocial factors for daily physical activity. Future research and clinical investigations should empirically test the use of strategies to modify these factors for promoting daily physical activity in community-dwelling adults with stroke.Implications for rehabilitationInterventions to increase physical activity after stroke are needed.Outcomes expectations, self-efficacy, self-regulation, and social support were reported by participants as important psychosocial factors underlying daily physical activity.These psychosocial factors should be explored with individual patients and clients to determine which are most deficient, and where amenable to change, targeted for intervention to promote daily physical activity.
更好地理解中风幸存者日常身体活动(即全天进行的身体活动)背后的心理社会因素,可用于制定促进中风后身体活动的干预措施,特别是对于那些难以进行锻炼的个体。对15名能够行走、居住在社区的中风幸存者进行了深入的定性访谈。以社会认知理论为指导,使用定向内容分析法对访谈记录进行分析,以调查日常身体活动的结果期望、自我效能感、自我调节和社会支持。参与者报告称,身心健康、独立性和康复是重要的结果期望。自我效能感通过心理认知和掌握经验得到增强。计划、解决问题、回顾表现以及建立需要身体活动的日常习惯是重要的自我调节策略。社会支持提供了赞扬、鼓励和身体上的帮助,但当朋友和家人过度保护时也会成为障碍。参与者报告称,所调查的社会认知理论结构是日常身体活动的重要心理社会因素。未来的研究和临床调查应通过实证检验使用策略来改变这些因素,以促进社区居住的中风成年患者的日常身体活动。
对康复的启示
需要采取干预措施来增加中风后的身体活动。
参与者报告称,结果期望、自我效能感、自我调节和社会支持是日常身体活动背后的重要心理社会因素。
应与个体患者和客户探讨这些心理社会因素,以确定哪些因素最缺乏,以及在哪些因素易于改变的情况下,针对这些因素进行干预以促进日常身体活动。