School of Health Sciences, University of Brighton, Eastbourne, UK.
Centre for Health and Social Care Improvement, School of Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.
Scand J Caring Sci. 2021 Mar;35(1):104-114. doi: 10.1111/scs.12824. Epub 2020 Feb 17.
Despite substantial reorganisation of stroke unit provision in the United Kingdom, limited qualitative research has explored how stroke survivors experience the acute stroke unit. This hermeneutic phenomenological study used accounts from four stroke survivors who experienced one of two acute stroke units. Through detailed analysis, the acute stroke unit emerged as a meaningful space, in two distinct but interconnected forms. As holding space, the unit was understood to offer protection and safe haven, as the stroke survivors looked to cope and respond to the temporal, bodily, biographical disruption and significant vulnerability brought about by stroke and by being in hospital. Holding was fulfilled by different people (including their fellow stroke survivors) and reflected a human response to human need and existential vulnerability. This space, and the practices within it, functioned to hold them intimately but also at a distance from their prestroke lifeworld. As such, the acute stroke unit holding space was intertwined with how it supported, encouraged or provoked transition. In the transitional space of the acute stroke unit, stroke survivors described how they survived the hospital-healthcare space, stroke unit and poststroke space. This paper articulates how transition was meaningfully signified through its absence or presence, as they transformed, relinquished or re-asserted their 'self', and in one case, recovered whilst 'in there'. The findings of this study provide phenomenological insight into stroke survivors' lived experience, the meaningful holding and transitional contribution of the unit, and how these spatial forms were intertwined. These insights are discussed in relation to the existing evidence base and stroke unit provision.
尽管英国在脑卒中单元的设置方面进行了大量的重组，但很少有定性研究探讨脑卒中幸存者在急性脑卒中单元中的体验。这项解释性现象学研究使用了 4 名经历过两种急性脑卒中单元之一的脑卒中幸存者的叙述。通过详细的分析，急性脑卒中单元呈现出两种截然不同但相互关联的形式，成为一个有意义的空间。作为容纳空间，单元被理解为提供保护和安全的避难所，脑卒中幸存者试图应对和应对由中风以及住院带来的时间、身体、传记上的中断和巨大的脆弱性。容纳是由不同的人（包括他们的脑卒中同伴）来完成的，反映了人类对人类需求和存在脆弱性的反应。这个空间及其内部的实践，不仅将他们紧密地容纳在其中，而且将他们与他们的前中风生活世界保持一定的距离。因此，急性脑卒中单元的容纳空间与它如何支持、鼓励或引发转变交织在一起。在急性脑卒中单元的过渡空间中，脑卒中幸存者描述了他们如何在医院-医疗保健空间、脑卒中单元和中风后空间中幸存下来。本文阐明了过渡是如何通过其存在或缺失来有意义地表示的，因为他们在转变、放弃或重新确立自己的“自我”，在一个案例中，在“那里”恢复了。这项研究的结果提供了对脑卒中幸存者生活体验、单元的有意义容纳和过渡贡献的现象学见解，以及这些空间形式是如何交织在一起的。这些见解是在与现有证据基础和脑卒中单元设置相关的背景下讨论的。
