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重新校准希望:中风后失语症患者的纵向研究。

Recalibrating hope: A longitudinal study of the experiences of people with aphasia after stroke.

机构信息

Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.

School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand.

出版信息

Scand J Caring Sci. 2020 Jun;34(2):428-435. doi: 10.1111/scs.12745. Epub 2019 Sep 5.

Abstract

BACKGROUND

Hope is a critical resource for people with aphasia after stroke, sustaining people though times of distress and uncertainty and providing motivation. In the first months after stroke, hope is vulnerable to different influences, and people can struggle to identify and work towards hopes for the future. We have little knowledge about how people with aphasia experience hope in the longer term after stroke.

OBJECTIVES

To identify how people with aphasia experience hope 1 year after stroke and how hope may change in the year after stroke.

METHODS

The study used an Interpretive Description methodology. Interviews were conducted with four people with aphasia who had been interviewed 1 year previously. These were analysed using content analysis.

RESULTS

All people reported a broad sense of hope for the future. They described an active process of recalibrating their early poststroke hopes through a process of reflecting on past progress, current function and what they considered might be possible and desirable in the future. People were able to develop 'new' hopes that were meaningful and seemingly achievable when they had a sense of a possible, desirable future. Those who struggled to see a possible future maintained a hope that things will be good. Social supports, a sense of progress, engagement in meaningful activities and interactions appeared crucial in helping people (re)develop hopes for their future.

CONCLUSIONS

Hope and hopes for the future gradually changed after stroke. Hope, identity and social connectedness were closely entwined and could enable people to both dwell in the present and move towards desired futures. This research suggests clinicians should prioritise creating hope-fostering environments which support people to develop hope for their future.

摘要

背景

希望是中风后失语症患者的重要资源,它在困难和不确定时期支撑着人们,并提供动力。在中风后的头几个月,希望容易受到不同因素的影响,人们可能难以确定和努力实现对未来的希望。我们对中风后较长时间内失语症患者的希望体验知之甚少。

目的

确定中风 1 年后失语症患者的希望体验,以及希望在中风后 1 年内可能如何变化。

方法

本研究采用解释性描述方法。对 4 名中风后 1 年接受过访谈的失语症患者进行了访谈。使用内容分析对这些访谈进行了分析。

结果

所有人都对未来有广泛的希望。他们描述了一个积极的过程,通过反思过去的进展、当前的功能以及他们认为未来可能和可取的事情,重新调整他们早期中风后的希望。当人们对未来有一个可能的、理想的感觉时,他们能够发展出有意义且看似可行的“新”希望。那些难以看到未来可能性的人则保持着对未来会更好的希望。社会支持、进步感、参与有意义的活动和互动似乎对帮助人们(重新)发展对未来的希望至关重要。

结论

希望和对未来的希望在中风后逐渐发生变化。希望、身份和社会联系紧密交织,使人们既能活在当下,又能走向理想的未来。这项研究表明,临床医生应该优先创造促进希望的环境,支持人们对未来的希望。

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