Govender Pragashnie, Naidoo Deshini, Bricknell Kiara, Ayob Zainab, Message Holly, Njoko Sibongiseni
School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban.
Afr J Prim Health Care Fam Med. 2019 Apr 24;11(1):e1-e8. doi: 10.4102/phcfm.v11i1.1806.
The South African health system has policies and strategies to ensure effective rehabilitation and reintegration of individuals who have survived a cerebrovascular accident into their respective communities. However, implementation of such guidelines remains an issue.
This study sought to explore cerebrovascular accident (CVA) survivors' experiences of community integration.
The study was located in a peri-urban community within the KwaZulu-Natal Province, South Africa.
An explorative qualitative study with eight purposively selected CVA survivors was conducted via semi-structured individual interviews. Data were audio-recorded and manually transcribed prior to thematic analysis. Trustworthiness of the study was maintained by strategies such as analyst triangulation, an audit trail and use of thick descriptions. Ethical principles of autonomy, informed consent, confidentiality and privacy were also maintained in the study.
Six themes emerged that highlighted (1) loss of autonomy and roles, (2) barriers to community reintegration, (3) social isolation of participants, (4) finding internal strength, (5) enablers of community reintegration including the positive influence of support and the benefits derived from rehabilitation and (6) recommendations for rehabilitation.
The study revealed both positive and negative influences that impact CVA survivors' ability to effectively reintegrate into their respective communities following a CVA. Recommendations include the need for education and awareness around access to rehabilitation services for CVA survivors, advice on how to improve CVA survivors' ability to mobilise in the community and make environmental adaption to facilitate universal access, provision of home programmes and caregiver training for continuity of care and for inclusion of home-based rehabilitation into current models of care.
南非卫生系统制定了政策和策略，以确保脑血管意外幸存者能够有效康复并重新融入各自的社区。然而，这些指导方针的实施仍然是一个问题。
本研究旨在探索脑血管意外（CVA）幸存者的社区融入经历。
该研究位于南非夸祖鲁-纳塔尔省的一个城郊社区。
通过半结构化的个人访谈，对八名有目的地挑选出的CVA幸存者进行了探索性定性研究。在进行主题分析之前，对数据进行了录音和手动转录。通过分析人员三角验证、审计跟踪和使用详细描述等策略来维持研究的可信度。研究还遵循了自主、知情同意、保密和隐私等伦理原则。
出现了六个主题，突出了（1）自主性和角色的丧失，（2）社区重新融入的障碍，（3）参与者的社会孤立，（4）找到内在力量，（5）社区重新融入的促进因素，包括支持的积极影响以及康复带来的益处，以及（6）康复建议。
该研究揭示了影响CVA幸存者在脑血管意外后有效重新融入各自社区能力的积极和消极影响。建议包括需要开展关于CVA幸存者获得康复服务的教育和提高认识，提供关于如何提高CVA幸存者在社区中活动能力和进行环境适应以促进普遍获得服务的建议，提供家庭方案和照顾者培训以确保持续护理，并将居家康复纳入当前护理模式。
