Introduction
Active
patient participation is an important factor in optimizing post-stroke
recovery, yet it is often low, regardless of stroke severity. The
reasons behind this trend are unclear.
Purpose
To
explore how people who have suffered a stroke, perceive the transition
from independence to dependence(So you've already given up on getting your patients fully recovered?) and whether their role in post-stroke
rehabilitation influences active participation.
Methods
In-depth
interviews with 17 people who have had a stroke. Data were analyzed
using systematic text condensation informed by the concept of autonomy
from enactive theory.
Results
Two
categories emerged. The first captures how the stroke and the resultant
hospital admission produces a shift from being an autonomous subject to
“an object on an assembly line.” Protocol-based investigations,
inactivity, and a lack of patient involvement predominantly determine
the hospital context. The second category illuminates how people who
have survived a stroke passively adapt to the hospital system, a
behavior that stands in contrast to the participatory enablement
facilitated by community. Patients feel more prepared for the transition
home after in-patient rehabilitation rather than following direct
discharge from hospital.
Conclusion
Bodily
changes, the traditional patient role, and the hospital context
collectively exacerbate a reduction of individual autonomy. Thus, an
interactive partnership between people who survived a stroke and
multidisciplinary professionals may strengthen autonomy and promote
participation after a stroke.
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