Objective: To find out about the experiences of stroke patients concerning their falling ill, their stay in hospital, discharge and homecoming.
Design: Qualitative methods using in-depth interviews.
Subjects and setting: Nine strategically chosen patients and in five cases near family members were interviewed in their homes four months post stroke and following care at the Stroke Centre, University Hospital of Northern Sweden, Umea°.
Results: Three main categories with subcategories were brought to the fore from the interviews: ‘Responsible and implicated’, ’Depersonalized object for caring measures’ and ‘The striving for repersonalization and autonomy’. The patients got the most important insights and understanding about their state and the consequences when they came home.
Conclusion: The three main categories that were found mirror the crisis which becoming ill entails and the process gone through when the individual takes control again of his or her life. The patients saw coming home as an important factor for their recovery and rehabilitation. The health care system needs to develop strategies to make use of the power of this attitude with the patients and to use the patients' own milieu in rehabilitation after stroke.
Get full access to this article
View all access options for this article.
References
1.
1 Stroke. The Swedish Council for Technology Assessment in Health Care. Stockholm 1992 (English version available at http://www.sbu.se/admin/index.asp). (Slaganfall. Statens Beredning för Utvärdering av Medicinsk Metodik; SBU. Stockholm: Nordstedts Tryckeri AB, 1992. In Swedish).
2.
2 Duncan PW. Stroke disability. Phys Ther1994; 74: 399-407.
3.
3 Kotila M, Waltimo O, Niemi M-L, Laaksonen R, Lempinen M. The profile of recovery from stroke and factors influencing outcome. Stroke1984; 15: 1039-1044.
4.
4 Bonita R, Beaglehole R. Recovery of motor function after stroke. Stroke1988; 19: 1497-1500.
5.
5 Dombovy ML, Basford JR, Whisnant J, Bergstrahl EJ. Disability and use of rehabilitation service following stroke in Rochester, Minnesota 1975-1979. Stroke1987; 18: 830-836.
6.
6 Dijkerman HC, Wood VA, Hewer RL. Long-term outcome after discharge from stroke rehabilitation unit. J R Coll Physicians, London1996; 30: 538-546.
7.
7 Patel M, Potter J, Perez I, Kalra L. The process of rehabilitation and discharge planning in stroke: a controlled comparison between stroke units. Stroke1998; 29: 2484-2487.
8.
8 Rodgers H, Soutter J, Kaiser W et al. Early supported hospital discharge following acute stroke: pilot study results. Clin Rehabil1997; 11: 280-287.
9.
9 Swedish National Guidelines for the Management of Stroke. National Board for Health and Welfare/ Medical Access & Result System. Stockholm 2000. (English version available at http://www.sos.se/FULLTEXT/102/2002-102-1/2002-102-1.htm). (Nationella riktlinjer för strokeva°rd. Socialstyrelsen, MARS, dok no: 2000-00-028, Stockholm, 2000. In Swedish)
10.
10 Aboderin I, Veneables G. Stroke management in Europa. Pan European consensus meeting on stroke management. J Intern Med1996; 240: 173-180.
12 McKevitt C, Redfern J, Mold F, Wolfe C. Qualitative studies of stroke: A systematic review. Stroke2004; 35: 1499-1505.
13.
13 Bendz M. The first years of rehabilitation after a stroke from two perspectives. Scand J Caring Sci, 2003; 17: 215-222.
14.
14 Wressle E, Öberg B, Henriksson C. The rehabilitation process for the geriatric stroke patient - an exploratory study of goal setting and interventions. Disabil Rehabil1999; 21:80-87.
15.
15 Bendz M. Rules of relevance after a stroke. Soc Sci Med2000; 15: 713-723.
16.
16 Lewinter M, Mikkelsen S. Patients' experience of rehabilitation after stroke. Disabil Rehabil1995; 17: 3-9.
17.
17 Maclean N, Pound P, Wolf C, Rudd A. Qualitative analysis of stroke patients' motivation for rehabilitation. BMJ2000; 321: 1051-1054.
18.
18 Hafsteinsdóttir TB, Grypdonck M. Being a stroke patient: a review of the literature. JAdv Nurs1997; 29: 580-588.
19.
19 Pound P. Gompertz P. A patient-centred study of the consequences of stroke. Clin Rehabil1998; 12: 338-347.
20.
20 Patton MQ. Qualitative evaluation and research methods. Newbury Park, CA: Sage, 1990.
21.
21 Miles MB, Huberman AM. Qualitative data analysis: a source book of new methods. Newburg Park, CA: Sage, 1984.
22.
22 Strauss A, Corbin J. Basics of qualitative research. Newburg Park, CA: Sage, 1990.
23.
23 Anderson R. Patient empowerment and the traditional medical model. A case of irreconcilable differences?Diabetes Care1995; 18: 412-415.
24.
24 Weaver SK, Wilson JF. Moving toward patient empowerment. Nurs Health Care1994; 15: 480-483.
25.
25 Brody DS. The patient's role in clinical decision making. Ann Intern Med1980; 93: 718-722.
26.
26 Jarrett N, Paynes S. A selective review of the literature on nurse-patient communication: has the patient's contribution been neglected?JAdv Nurs1995; 22:72-78.
27.
27 Anderson R. The aftermath of stroke. Cambridge: Cambridge University Press, 1992.
28.
28 Wiles R, Pain H, Buckland S, McLellan L. Providing appropriate information to patients and carers following a stroke. JAdv Nurs1998; 28: 794-801.
29.
29 Lupton D. Medicine as culture. Illness, disease and the body in western societies. London: Sage, 1994.
