http://informahealthcare.com/doi/abs/10.3109/09638288.2014.976717
Ton Satink, Edith H.C. Cup, Bert J. M. de Swart, and Maria W. G. Nijhuis-van der Sanden
1Department of Occupational Therapy, and
2Research Group Neurorehabilitation, HAN University of Applied Sciences,
Nijmegen
, The Netherlands,
3Scientific Institute for Quality of Health Care, and
4Department of Rehabilitation, Radboud University Medical Center,
Nijmegen
, The NetherlandsAbstract
Purpose:
Self-management has become an important concept in stroke
rehabilitation. This study explored allied healthcare professionals'
(AHPs) perceptions and beliefs regarding the self-management of stroke
survivors and their knowledge and skills regarding stroke
self-management interventions. Method: Four focus group
interviews were conducted with 27 professionals. Verbal questions and
mind mapping were used to collect data. A constant comparative framework
was used for analysis. Results: The AHPs discussed different
levels of post-stroke self-management, depending on factors such as
pre-stroke skills, recovery-phases post-stroke and cognitive abilities
of the stroke patients. They hesitated about stroke clients' capacities
to self-manage. AHPs questioned whether their own attitudes and skills
were really supportive for stroke clients' self-management and
criticised stroke services as being too medically oriented. They
recommended that self-management programmes should focus both on clients
and caregivers and be delivered at peoples' homes. Conclusion:
Professional perceptions and beliefs are important factors to take into
account when implementing stroke self-management programmes. Before
professionals can enable stroke survivors to self-manage, they first
need support in acquiring knowledge and skills regarding post-stroke
self-management. Moreover, professionals could benefit from behavioural
change models, and professionals recognised that stroke self-management
interventions would be most beneficial when delivered post-discharge at
people's homes.Implications for Rehabilitation
- Post-stroke self-management is a learning process with different levels dependent on pre-stroke lifestyle and self-management skills, the post-stroke phase of recovery, the cognitive abilities of stroke survivors and the support of caregivers (co-management).
- Persons with cognitive impairments are not persons who cannot learn to self-manage; rather, they need more specific self-management support.
- Case studies describing the abilities of stroke survivors, who are successful in self-management post-stroke, can help to develop “ability oriented” stroke-illness scripts.
- Addressing “ability oriented” stroke-illness scripts in bachelor and post-graduate education will enhance positive professional beliefs concerning the self-management post-stroke, and will help professionals in coaching in stroke survivors' goal setting in self-management programmes.
- Professionals' account suggests that stroke self-management programmes should also be delivered post-discharge at stroke survivors' own homes.
Read More: http://informahealthcare.com/doi/abs/10.3109/09638288.2014.976717
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