基于互联网的日常生活赋能活动干预策略:中风患者体验的定性研究
The Internet-Based Intervention Strategies for Empowering Activities in Everyday Life: Qualitative Study of Experiences of Clients With Stroke.
作者信息
Barcheus Ida-Maria, Ranner Maria, Månsson Lexell Eva, Jacobsson Lars, Larsson-Lund Maria
机构信息
Division of Health, Medicine and Rehabilitation-Occupational Therapy, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
出版信息
JMIR Form Res. 2024 Aug 15;8:e56189. doi: 10.2196/56189.
BACKGROUND
There is a need to enhance access to and support for self-management of activities in everyday life after a stroke. Internet-based solutions have the potential to contribute to this development. Consequently, an internet-based intervention called Strategies for Empowering Activities in Everyday Life (SEE) was developed. The intervention aims to assist clients in developing management strategies that promote a healthy distribution and balanced engagement in various activities performed in different places and with other people. To further support the development and feasibility of this intervention, more knowledge is needed about clients' experiences during the intervention process.
OBJECTIVE
This study aims to explore and describe how clients with stroke experienced the SEE intervention process and whether participation in SEE influenced their experience of everyday life.
METHODS
Overall, 9 clients with stroke who received SEE participated in the study-4 (44%) women and 5 (56%) men aged 37 to 73 years. Qualitative interviews about experiences with SEE were conducted twice during the intervention process with each participant. The data were analyzed using the constant comparative method of grounded theory.
RESULTS
The participants' experiences with the intervention process of SEE formed the core category, conceptualized as The relevance of and readiness for entering a change process in activities of everyday life differ among clients, constituting of two main categories: (1) an eye-opener providing agency for a change process and (2) never beginning a change process in activities in everyday life. The results showed that the relevance of and readiness for SEE differed between the participants. The experiences of 78% (7/9) of the participants reflected that the intervention process provided them with an agency to drive their own change process for activities in everyday life to promote health. Overall, 22% (2/9) of the participants refrained from entering a change process during SEE as they did not recognize any need for changes in their activities. When SEE was relevant and adopted as expected, the participants described it as an eye-opener for how they can alter their health based on how they distribute and spend their time on various activities.
CONCLUSIONS
SEE has the potential to support clients' development of self-management and to take an active role in influencing their engagement in activities in everyday life and health. This study identified necessary improvements in the educational program for professionals to enhance delivery and strengthen the therapeutic mechanisms of SEE for future research. To effectively implement internet-based interventions such as SEE, it is crucial to identify clients who express a need for self-management in activities and are ready to invest the effort required to adopt a change process. Furthermore, it is indicated that participants' self-analysis of their everyday activities empowers them to adopt new self-management strategies, which can also benefit other interventions.
背景
中风后需要增加对日常生活活动自我管理的获取途径并提供支持。基于互联网的解决方案有潜力推动这一发展。因此,开发了一种名为“日常生活活动赋能策略”(SEE)的基于互联网的干预措施。该干预旨在帮助患者制定管理策略,以促进在不同场所与他人进行的各种活动中实现健康的分配和平衡参与。为了进一步支持该干预措施的开发和可行性,需要更多关于患者在干预过程中体验的知识。
目的
本研究旨在探索和描述中风患者对SEE干预过程的体验,以及参与SEE是否影响了他们的日常生活体验。
方法
总体而言,9名接受SEE的中风患者参与了研究,其中4名(44%)为女性,5名(56%)为男性,年龄在37至73岁之间。在干预过程中,对每位参与者进行了两次关于SEE体验的定性访谈。使用扎根理论的持续比较法对数据进行分析。
结果
参与者对SEE干预过程的体验形成了核心类别,概念化为“日常生活活动中进入改变过程的相关性和准备程度在患者中存在差异”,包括两个主要类别:(1)为改变过程提供动力的启发因素;(2)在日常生活活动中从未开始改变过程。结果表明,参与者对SEE的相关性和准备程度各不相同。78%(7/9)的参与者的体验反映出干预过程为他们提供了动力,促使他们推动自己在日常生活活动中的改变过程以促进健康。总体而言,22%(2/9)的参与者在SEE期间没有进入改变过程,因为他们没有意识到自己的活动有任何改变的必要。当SEE相关且如预期般被采用时,参与者将其描述为一个启发,让他们明白如何根据自己在各种活动中的时间分配和花费方式来改变健康状况。
结论
SEE有潜力支持患者自我管理的发展,并在影响他们参与日常生活活动和健康方面发挥积极作用。本研究确定了专业人员教育计划中必要的改进措施,以加强SEE的实施并强化其治疗机制,供未来研究使用。为了有效实施诸如SEE这样的基于互联网的干预措施,识别那些表示在活动中需要自我管理并准备好投入采用改变过程所需努力的患者至关重要。此外,研究表明参与者对日常活动的自我分析使他们能够采用新的自我管理策略,这也可能使其他干预措施受益。
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