Abstract
Stroke self-management programs provide a comprehensive approach to managing the day-to-day aspects of living with the effects of stroke. The impact of these programs on participants has not been previously explored. This presentation will share the results of a qualitative study exploring the process of adaptation as described by five stroke survivors following their participation in a stroke self-management program.
Primary Author and Speaker: Riqiea Kitchens
Self-management programs use a comprehensive approach to address the day to day management of persons living with chronic conditions. Stroke specific self-management programs are designed to address the specific needs of stroke survivors. Occupational Adaptation describes the process a person experiences when they encounter occupational challenges and supports the development of an appropriate response to the occupational challenge to achieve mastery. The purpose of this qualitative study sought to explore the adaptive process and experience of participants who completed a stroke self-management program. A phenomenological design was used for this study. Survivors were invited to participate in the study if they had participated in at least 7 of 12 of the stroke self-management classes within the past one year and were able to engage in a face to face interview conducted in English. Nine stroke survivors met inclusion criteria. Two stroke survivors were unable to be contacted for the study and two stroke survivors were not able to participate due to schedule conflicts. Five participants consented to participate in the study. A 1:1 semi-structured interview was conducted. An Occupational Adaptation lens was used to develop the interview questions. All interviews were audio recorded. The researcher used a notebook to take field notes during and after the interview. The interviews were transcribed and coded for thematic analysis. Thick description, the use of multiple coders, reflective journaling, use of an audit trail, and use of a constant comparative process during the coding, category, and theme development were used to ensure trustorthiness of the data. Four themes emerged from the data and include:
1. Knowledge acquisition promote a need for change, generating an adaptive response
2. Behavioral change and adjustment in routines- intrinsic motivation
3. Increased proactivity and personal responsibility- occupational response
4. Evaluating response outcomes: Physiological and emotional changes in health
This study provides insight into the survivors’ lived experience through the application of theoretical concepts in a creative and compassionate way. The results of this study highlight the impact of stroke self-management education through the lens of the occupational adaptation. As the participants gained an increase in knowledge regarding their stroke condition they began to make changes in their behavior and reported improved responsibility in managing their health. Several participants reported physiological changes including healthier blood glucose and blood pressure readings, and improved medication adherence as a result of participating in the program. This suggests that stroke self-management education can be impactful in supporting stroke survivors as they learn to adapt successfully to life after stroke. Occupational therapists are important in facilitating this adjustment. This study offers a potential area for emerging occupational therapy practice.
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