Becker Ines, Maleka Morake Douglas, Stewart Aimee, Jenkins Matthew, Hale Leigh
Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Disabil Rehabil. 2022 Jun;44(12):2815-2822. doi: 10.1080/09638288.2020.1839792. Epub 2020 Nov 2.
Optimal community reintegration is a key rehabilitation outcome post-stroke. This concept has been investigated in many countries but not qualitatively in New Zealand. We explored perceptions about community reintegration of stroke survivors living in southern New Zealand.
Qualitative interviews were used to collect data. Recruitment was via local stroke clubs, inviting adult stroke survivors (stroke duration > six months, any severity or type) living in the lower South Island. Data were analysed using the General Inductive Approach.
Eight stroke survivors (two female, six males; age range 50-80 years, mean 66 years (SD = 12); mean time since stroke 6.5 (SD = 4) years) participated. Participants' perceptions of what is integral to reintegration into their community were shaped by four themes, namely: (1) personal relationships, (2) re-establishing normality (old and new), (3) purpose in life, and (4) independence.
Stroke survivors in New Zealand hold many similar perceptions about optimal community reintegration with those living elsewhere. Key to successful community reintegration, irrespective of geography, culture and ethnicity, appears to be involvement in meaningful activities, and reduced reliance on others whilst maintaining or developing good social relationships. These fundamental components are then contextually nuanced by what is meaningful and important to the individual.IMPLICATIONS FOR REHABILITATIONOptimal community reintegration post-stroke is arguably the key goal of rehabilitation, and thus should be enabled and measured.To optimise community reintegration post-stroke, rehabilitation should focus on enabling stroke survivors' social relationships, independent community mobility, and engagement in meaningful activities.Optimal community reintegration post-stroke is however contextual. Rehabilitation professionals must understand what each patient considers successful community reintegration to be for them and tailor their rehabilitation accordingly.
最佳的社区重新融入是中风后康复的关键成果。这一概念在许多国家都有研究,但在新西兰尚未进行定性研究。我们探讨了新西兰南部中风幸存者对社区重新融入的看法。
采用定性访谈收集数据。通过当地中风俱乐部招募居住在南岛下部的成年中风幸存者(中风持续时间>6个月,任何严重程度或类型)。使用一般归纳法分析数据。
8名中风幸存者(2名女性,6名男性;年龄范围50 - 80岁,平均66岁(标准差 = 12);中风后平均时间6.5(标准差 = 4)年)参与了研究。参与者对重新融入社区不可或缺因素的看法受四个主题影响,即:(1)人际关系,(2)重新建立常态(新旧常态),(3)生活目的,以及(4)独立性。
新西兰的中风幸存者与其他地方的幸存者对最佳社区重新融入有许多相似的看法。无论地理位置、文化和种族如何,成功实现社区重新融入的关键似乎是参与有意义的活动,在维持或发展良好社会关系的同时减少对他人的依赖。这些基本要素随后会因个人认为有意义和重要的事物而在具体情境中有细微差别。
对康复的启示
中风后最佳的社区重新融入可以说是康复的关键目标,因此应该加以促进和衡量。
为了优化中风后的社区重新融入,康复应侧重于促进中风幸存者的社会关系、独立的社区活动能力以及参与有意义的活动。
然而,中风后最佳的社区重新融入是因具体情境而异的。康复专业人员必须了解每位患者认为对他们来说成功的社区重新融入是什么样的,并据此调整康复方案。