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早期卒中康复期间的自我导向上肢方案:护士、治疗师和卒中幸存者观点的定性研究。

A self-directed upper limb program during early post-stroke rehabilitation: A qualitative study of the perspective of nurses, therapists and stroke survivors.

机构信息

Rehabilitation Centre, Tan Tock Seng Hospital, Singapore, Singapore.

Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.

出版信息

PLoS One. 2022 Feb 4;17(2):e0263413. doi: 10.1371/journal.pone.0263413. eCollection 2022.

Abstract

INTRODUCTION

This study aimed to explore the perspective of nurses, therapists and stroke survivors on the performance of upper limb self-exercise and use outside therapy during early inpatient stroke rehabilitation.

METHODS

A descriptive qualitative approach was used in focus groups with nurses (n = 21) and therapists (n = 8), as well as in-depth semi-structured interviews with stroke survivors (n = 8) who were undergoing subacute inpatient stroke rehabilitation. Inductive thematic analysis of data was performed according to participant group.

RESULTS

Nurses and therapists perceived that stroke survivors played a central role in determining the success of a self-directed upper limb program. Nurses perceived that stroke survivors needed a lot of prompting to be motivated to perform self-directed upper limb therapy outside therapy. Therapists perceived that not all stroke survivors would be able to perform self-directed upper limb therapy and deemed it important to consider stroke survivor factors before commencing a program. Although some stroke survivors expressed initial reservations with performing self-practice, many indicated that they would participate in the self-directed upper limb program because they wanted to recover faster.

CONCLUSION

A difference between the perspective of nurses/therapists and stroke survivors towards self-directed upper limb performance outside therapy was found. Deeper stroke survivor engagement and a shift in rehabilitation culture to encourage stroke survivor autonomy are important considerations for a self-directed upper limb program. Teamwork amongst healthcare professionals and families is essential to support stroke survivors to participate in a self-directed upper limb program during early inpatient stroke rehabilitation.

摘要

简介

本研究旨在探讨护士、治疗师和中风幸存者对上肢自我锻炼和康复早期住院期间治疗外使用的看法。

方法

采用焦点小组的描述性定性方法,对护士(n=21)和治疗师(n=8)进行了研究,并对接受亚急性住院中风康复的中风幸存者(n=8)进行了深入的半结构化访谈。根据参与者的组别对数据进行了归纳主题分析。

结果

护士和治疗师认为中风幸存者在决定自我指导的上肢计划的成功方面起着核心作用。护士认为,中风幸存者需要很多激励才能有动力在治疗外进行自我指导的上肢治疗。治疗师认为,并非所有中风幸存者都能够进行自我指导的上肢治疗,在开始计划之前,考虑中风幸存者的因素非常重要。尽管一些中风幸存者对进行自我实践最初持保留态度,但许多人表示他们将参加自我指导的上肢计划,因为他们希望更快地康复。

结论

发现护士/治疗师和中风幸存者对治疗外自我指导的上肢表现的看法存在差异。更深入的中风幸存者参与以及鼓励中风幸存者自主的康复文化转变是自我指导的上肢计划的重要考虑因素。医疗保健专业人员和家庭之间的团队合作对于支持中风幸存者在早期住院中风康复期间参与自我指导的上肢计划至关重要。

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