Pound P, Gompertz P, Ebrahim S
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK.
Clin Rehabil. 1998 Aug;12(4):338-47. doi: 10.1191/026921598677661555.
To explore subjective accounts of the consequences of stroke.
Qualitative methods using depth interviews.
Forty people sampled ten months post stroke from a hospital stroke register which was established in two adjacent health districts in North Thames Regional Health Authority.
Interviewees reported a number of ways in which the stroke had affected their daily lives, including difficulty with leaving the house, doing the housework, pursuing former leisure activities, inability to walk in the way they wanted, problems with communicating, washing, bathing and dressing, and with confusion and deteriorating memory. In all these areas people described the loss of social contact that accompanied these changes, and the loss of valued roles which had been embedded in the everyday functions they had previously performed. In general, people over the age of 70 were more seriously affected.
The type of changes which people reported would not easily have been captured using standardized outcome measures, pointing to the value of qualitative methods in providing subjective accounts. In terms of clinical practice, there is a need to reduce people's isolation after stroke by providing home visits after discharge, particularly to those living alone, and also by reducing disability through rehabilitation and by tackling the environmental obstacles which can imprison people in their homes. The findings suggest that many people with stroke would benefit from being able to talk about the changes which have occurred. Imaginative proposals are needed to develop ways to help replace the loss of activities, social contacts and social roles, particularly among older people with stroke.
探讨中风后果的主观描述。
采用深度访谈的定性研究方法。
从北泰晤士河地区卫生局两个相邻健康区设立的医院中风登记册中，选取了40名中风后10个月的患者。
受访者报告了中风影响他们日常生活的多种方式，包括出门困难、做家务困难、无法进行以前的休闲活动、不能按自己期望的方式行走、沟通、洗漱、洗澡和穿衣方面存在问题，以及出现意识混乱和记忆力衰退。在所有这些方面，人们描述了伴随这些变化而来的社交联系的丧失，以及他们以往日常活动中所包含的重要角色的丧失。总体而言，70岁以上的人受影响更严重。
人们报告的这些变化类型很难通过标准化的结果测量方法捕捉到，这表明定性研究方法在提供主观描述方面具有价值。在临床实践方面，有必要通过出院后家访来减少中风患者的孤立状态，尤其是对独居患者，同时通过康复治疗减少残疾，并消除那些可能使人们困在家中的环境障碍。研究结果表明，许多中风患者能够谈论所发生的变化会从中受益。需要提出富有想象力的建议，以开发帮助弥补活动、社交联系和社会角色丧失的方法，特别是针对老年中风患者。
