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Elf M, Norin L, Meijering L, Pessah-Rasmussen H, Suhonen R, Zingmark M, Kylén M. Rehabilitation at Home With the Development of a Sustainable Model Placing the Person's Needs and Environment at Heart: Protocol for a Multimethod Project. JMIR Res Protoc 2024; 13:e56996. [PMID: 39042448 PMCID: PMC11303889 DOI: 10.2196/56996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Each year, more than 1.5 million people in Europe have a stroke, and many experience disabilities leading to activity and participation restrictions. Home-based rehabilitation is the recommended approach for stroke rehabilitation, in line with the international shift to integrated care. Despite this, rehabilitation often focuses on the person's physical functions, not the whole life situation and opportunities to live an active life. Given that rehabilitation today is often provided in the person's home, there is a need to develop new models that consider the rehabilitation process as situated in the everyday living environment of persons with stroke. This project is grounded in experiences from our ongoing research, where we study the importance of the home environment for health and participation among persons with stroke, rehabilitated at home. This research has shown unmet needs, which lead to suboptimal rehabilitation outcomes. There is a need for studies on how to use environmental resources to optimize stroke rehabilitation in the home setting. OBJECTIVE The overarching objective of the project is to develop a new practice model for rehabilitation where the needs of the person are the starting point and where the environment is considered. METHODS The project will be conducted in partnership with persons with stroke, significant others, health care professionals, and care managers. Results from a literature review will form the base for interviews with the stakeholders, followed by co-designing workshops aiming to create a new practice model. Focus groups will be held to refine the outcome of the workshops to a practice model. RESULTS This 4-year project commenced in January 2023 and will continue until December 2026. The results of the literature review are, as of April 2024, currently being analyzed. The ethics application for the interviews and co-design phase was approved in October 2023 and data collection is ongoing during spring 2024. We aim to develop a practice model with stakeholders and refine it together with care managers and decision makers. The outcome is a new practice model and implementation plan, which will be achieved in autumn 2026. CONCLUSIONS The project contributes with a prominent missing puzzle to optimize the rehabilitation process by adding a strong focus on user engagement combined with integrating different aspects of the environment. The goal is to improve quality of life and increase reintegration in society for the large group of people living with the aftermath of a stroke. By co-designing with multiple stakeholders, we expect the model to be feasible and sustainable. The knowledge from the project will also contribute to an increased awareness of the importance of the physical environment for sustainable health care. The findings will lay the foundation for future upscaling initiatives. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56996.
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Affiliation(s)
- Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lizette Norin
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Hélène Pessah-Rasmussen
- Department of Neurology, Rehabilitation Medicine, Memory disorders and Geriatrics, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, The Wellbeing Services County of Southwest Finland, Turku, Finland
| | - Magnus Zingmark
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
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Elf M, Slaug B, Ytterberg C, Heylighen A, Kylén M. Housing Accessibility at Home and Rehabilitation Outcomes After a Stroke: An Explorative Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:172-186. [PMID: 37287249 PMCID: PMC10621028 DOI: 10.1177/19375867231178313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To explore if aspects of the physical home environment are related to rehabilitation outcomes among community-living persons poststroke. BACKGROUND Research demonstrates that healthcare environments are important for high-quality care and that the design of the physical environment is associated with improved rehabilitation outcomes. However, relevant research focusing on outpatient care settings, such as the home, is sparse. METHODS In this cross-sectional study, data on rehabilitation outcomes, physical environmental barriers, and housing accessibility problems were collected during home visits of participants (N = 34), 3 months poststroke. Data were analyzed with descriptive statistics and correlation analysis. RESULTS Few participants had adapted their homes, and the relevance of the physical environment was not always discussed with the patient during discharge from the hospital. Accessibility problems were associated with suboptimal rehabilitation outcomes such as worse perceived health and recovery after stroke. Activities most restricted by barriers in the home concerned hand and arm use. Participants who reported one or more falls at home tended to live in houses with more accessibility problems. Perceived supportive home environments were associated with more accessible dwellings. CONCLUSIONS Many face problems adapting their home environments poststroke, and our findings highlight unmet needs that should be considered in the rehabilitation practice. These findings could be used by architectural planners and health practitioners for more effective housing planning and inclusive environments.
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Affiliation(s)
- Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Ann Heylighen
- Research[x]Design, Department of Architecture, KU Leuven, Belgium
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Health Sciences, Lund University, Sweden
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Elf M, Rasoal D, Zingmark M, Kylén M. The importance of context-a qualitative study exploring healthcare practitioners' experiences of working with patients at home after a stroke. BMC Health Serv Res 2023; 23:733. [PMID: 37415156 DOI: 10.1186/s12913-023-09735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Stroke significantly impacts individuals, leading to the need for long-lasting rehabilitation and adaptation to environmental demands. Rehabilitation after stroke is increasingly performed in patients' homes, and it is argued that rehabilitation in this context is more person-centred and positively impacts client outcomes. However, the role of environmental factors in this process is largely unknown. The aim of this study was to explore how multidisciplinary healthcare practitioners working with rehabilitation in the home after stroke consider possibilities and challenges in the environment and how environmental factors are documented in patients' records. METHODS Eight multidisciplinary healthcare practitioners working with home-based rehabilitation after stroke participated in two semistructured focus group sessions. Thematic analysis was used to analyse the transcripts of recorded focus group discussions. Data were also collected from patient history records (N = 14) to identify interventions to increase patients' opportunities to participate in activities inside and outside the home. These records were analysed using life-space mobility as a conceptual framework. RESULTS The analysis generated four overarching themes concerning possibilities and challenges in the environment: (1) the image of rehabilitation conflicts with place, (2) the person in the home reveals individual needs and capabilities, (3) environmental characteristics influence the rehabilitation practice, and (4) the person is integrated within a social context. The patient record analysis showed that most patients were discharged from hospital to home within four days. Assessments at the hospital mainly focused on basic activities of daily living, such as the patient's self-care and walking ability. Also at home, the assessments and actions primarily focused on basic activities with little focus on participation in meaningful activities performed in different life situations outside the home. CONCLUSIONS Our research suggests that one way to improve practice is to include the environment in the rehabilitation and consider the person´s life space. Interventions should focus on supporting out-of-home mobility and activities as part of person-centred stroke rehabilitation. This must be supported by clear documentation in the patient records to strengthen clinical practice as well as the communication between stakeholders.
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Affiliation(s)
- Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Dara Rasoal
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Magnus Zingmark
- Department of Health Sciences, Lund University, Lund, Sweden
- Health and Social Care Administration, Östersund, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umåe, Sweden
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden.
- Department of Health Sciences, Lund University, Lund, Sweden.
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Kylén M, Ytterberg C, von Koch L, Elf M. How is the environment integrated into post-stroke rehabilitation? A qualitative study among community-dwelling persons with stroke who receive home rehabilitation in Sweden. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1933-1943. [PMID: 34541725 DOI: 10.1111/hsc.13572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/17/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Studies have shown a need to consider environmental factors to best support the rehabilitation and recovery process after a stroke. In addition, despite intentions to increase individuals' participation in care and rehabilitation, patients and family members report weak participation. The aim of this study was to explore how the environment was integrated into rehabilitation at home from the perspective of patients after a stroke. We conducted as a qualitative study with 17 patients rehabilitated at home. Data on the participants' experiences of the rehabilitation process and their perceptions of how the environment was considered in the process were collected via interviews and analysed using qualitative content analysis. The main category that was constructed from the data was "Partial integration of person- environment dynamics in the rehabilitation", which was informed by three subcategories: (a) I recover in my home: Challenges and opportunities in the environment, (b) Following a generic approach to therapy: Limited integration of the environment, and (c) Informed more than involved. Our study showed that the environment was integrated in a limited manner. The participants were more informed about than involved in their planning of the rehabilitation. The results are important for informing the ongoing development of rehabilitation at home and person-centred care strategies.
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Affiliation(s)
- Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
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Kylén M, von Koch L, Wottrich AW, Elf M. Living with the aftermaths of a stroke in the era of the COVID-19 pandemic; the significance of home and close surroundings. Health Place 2022; 76:102852. [PMID: 35803042 PMCID: PMC9222220 DOI: 10.1016/j.healthplace.2022.102852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/22/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
Stay-at-home recommendations to reduce the spread of the COVID-19 virus have had a major impact on people's everyday lives. However, while the evidence indicates that such recommendations have caused distress, anxiety, and fear among the public, little is known about how persons living with complex health conditions, e.g., disability after stroke, have experienced and handled the situation. We interviewed fourteen participants (7 women, 7 men) aged 61–91 years living in ordinary housing during summer 2020 to explore how people who recovered after a stroke experienced their everyday lives in their homes and close surroundings during the COVID-19 pandemic recommendations. Three intertwined themes were constructed from the narrative data and the iterative thematic analysis: (1) Places within and out of reach, (2) Upholding activities–strategies and structures, and (3) Adapting to new circumstances. The findings suggest that places within reach were important to maintain activities and provide structure in daily life. The participants seemed to make use of their previous experiences of adjusting to new circumstances after stroke when adapting to living under the stay-at-home recommendations. In addition, feeling that they now shared the restrictions with all other people in society seemed to ease their situations. Access to nature and spaces in the close surroundings was essential for staying socially connected and receiving support in daily life. The significance of the home and the neighbourhood for health experiences among people who recently have had a stroke should inform rehabilitation interventions both during and after pandemics and environmental planning.
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Affiliation(s)
- Maya Kylén
- Dalarna University, School of Health and Welfare, Falun, Sweden; Lund University, Department of Health Sciences, Lund, Sweden.
| | - Lena von Koch
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden; Karolinska University Hospital, Stockholm, Sweden
| | - Annica Wohlin Wottrich
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden
| | - Marie Elf
- Dalarna University, School of Health and Welfare, Falun, Sweden
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Meijering L, Lettinga A. Hopeful adaptation after acquired brain injury: The case of late referrals in the Netherlands. Soc Sci Med 2021; 293:114651. [PMID: 34915241 DOI: 10.1016/j.socscimed.2021.114651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
A substantial number of people with 'mild' acquired brain injury (ABI) suffer from cognitive impairments that are not immediately acknowledged as such. Some are eventually referred to multidisciplinary rehabilitation care after months or years of suffering, which is why we have labelled them 'late referrals'. The aim of this paper is to add to the discussion on hopeful adaptation by focussing on the diverse adaptive strategies of late referrals. Hope is typically discussed as a positive emotion that can contribute to transformative processes, but that is also mirrored by despair. We conducted in-depth interviews with ten late referrals in the Netherlands. Our findings demonstrate that the trajectories of late referrals are characterised by wandering and navigating. Wandering is predominantly associated with feeling lost, and not knowing where one is going. While navigating is more purposeful, we found that our participants sometimes navigated in directions that turned out to be dead-end streets. We conclude that hopeful adaptation encompasses a circuitous way of trying and adapting and trying again. As a key recommendation for practice, we suggest that people with cognitive problems due to mild ABI should be supported in reducing the complexities of their everyday lives by taking up challenges one place at a time.
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Affiliation(s)
- Louise Meijering
- Population Research Centre (PRC), Faculty of Spatial Sciences, University of Groningen, the Netherlands.
| | - Ant Lettinga
- University Medical Center Groningen, Department of Epidemiology, the Netherlands.
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The experience of close personal relationships after stroke: scoping review and thematic analysis of qualitative literature. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background and Purpose:
Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.
Method:
Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.
Results:
While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.
Conclusions:
Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.
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Mossabir R, Milligan C, Froggatt K. Therapeutic landscape experiences of everyday geographies within the wider community: A scoping review. Soc Sci Med 2021; 279:113980. [PMID: 33990074 DOI: 10.1016/j.socscimed.2021.113980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
As community dwelling populations of older people and those living with chronic and life limiting conditions continue to grow, the role of everyday geographies, particularly of community based settings and activities, in supporting health and wellbeing has become a focus in both research and policy development. The therapeutic landscape scholarship provides a holistic view of how place promotes health and wellbeing, and has in recent years expanded its focus from reputable places of healing to everyday geographies. Based on a scoping review of 45 studies on everyday community based therapeutic landscapes, this paper identifies and critically examines the settings, populations and mechanisms of therapeutic experiences. It presents critical summaries of the scales and boundaries of landscapes; the diverse and dichotomous characteristics of places; the therapeutic benefits of proximal and distal socio-spatial interactions; the role of everyday settings and activities as sources of refuge, anchor and resonance and finally the broader social, cultural, political and economic contexts in which everyday therapeutic landscapes are embedded. In so doing the paper highlights the complex nature of everyday therapeutic landscape experiences and how this research can further inform the development of community based settings and activities that promote health and wellbeing. It also identifies areas for future research on everyday therapeutic landscapes.
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Wu C, Cheng J, Zou J, Duan L, Campbell JE. Health-related quality of life of hospitalized COVID-19 survivors: An initial exploration in Nanning city, China. Soc Sci Med 2021; 274:113748. [PMID: 33648821 PMCID: PMC7879027 DOI: 10.1016/j.socscimed.2021.113748] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/17/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
Understanding the health-related quality of life (HrQoL) of hospitalized COVID-19 survivors is an emerging global challenge arising from the current pandemic. A qualitative study of the experiences of sixteen hospitalized COVID-19 survivors from Nanning City, China, was conducted using semi-structured telephone interviews in May 2020. These first-hand accounts were critically and empirically analysed to identify emerging health and social issues, and provide potential solutions to improve survivors' quality of life. This in-depth, qualitative study of HrQoL for hospitalized COVID-19 survivors provides the first empirical evidence and conceptual framework with eight dimensions (physical symptoms, anxiety, trauma, economic loss, place-based identity, self-stigma, health self-interventions, and changing lifestyle) for understanding the physiological, psychological, socio-economic and health behavioral aspects of their daily lives. We argue that local and global governments should provide integrated healthcare, social and digital infrastructure to support this vulnerable group. More comparative and multi-disciplinary studies in this area are needed to generate academic standards of assessing health-related quality of life and produce good practice guidelines for promoting urban resilience in response to public health disasters.
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Affiliation(s)
- Chenhui Wu
- School of Geography and Planning, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou, 510275, PR China.
| | - Jianquan Cheng
- Department of Natural Sciences, Manchester Metropolitan University, Chester Street, M1 5GD, United Kingdom; Centre for Health Geographic Information and Education, Key Laboratory of Environment Change and Resources Use in Beibu Gulf, Nanning Normal University, 175 MingxiuDonglu Road, 530051, Nanning, PR China.
| | - Jun Zou
- Centre for Health Geographic Information and Education, Key Laboratory of Environment Change and Resources Use in Beibu Gulf, Nanning Normal University, 175 MingxiuDonglu Road, 530051, Nanning, PR China; The Fourth People's Hospital of Nanning, Erli-1 ChangGang Road, Xingning District, Nanning, 530023, PR China.
| | - Lian Duan
- Centre for Health Geographic Information and Education, Key Laboratory of Environment Change and Resources Use in Beibu Gulf, Nanning Normal University, 175 MingxiuDonglu Road, 530051, Nanning, PR China; School of Natural Resources and Surveying, Nanning Normal University, 175 MingxiuDonglu Road, 530051, Nanning, PR China.
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
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Yap KH, Warren N, Reidpath DD, Allotey P. Understanding Cognitive Impairment after Stroke: Stories from a Middle-Income Country. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Pedersen SG, Anke A, Aadal L, Pallesen H, Moe S, Arntzen C. Experiences of quality of life the first year after stroke in Denmark and Norway. A qualitative analysis. Int J Qual Stud Health Well-being 2020; 14:1659540. [PMID: 31547779 PMCID: PMC6781187 DOI: 10.1080/17482631.2019.1659540] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: This study aims to explore quality of life (QOL) during the first year of recovery after stroke in North Norway and Central Denmark. Method: Individual in-depth interviews with 11 stroke survivors were performed twelve months after stroke onset. An interpretative, inductive approach shaped the interview process and the processing of data. Results: We found that QOL reflected the individuals' reconstruction of the embodied self, which was identified by three intertwined and negotiating processes: a familiar self, an unfamiliar self, and a recovery of self. Further, we found that reconstruction of the embodied self and QOL could be framed as an ongoing and interrelated process of "being, doing, belonging and becoming". Enriching social relations, successful return to work, and continuity and presence in professional support during recovery enhanced the experience of QOL. Fatigue and sustained reduced function hindered participation in meaningful activities and influenced the perceived QOL negatively. Conclusions: The two countries differed in descriptions of continuity and support in the professional follow-up during the recovery process, influencing the degree of encouragement in reconstructing the embodied self. Reconstruction of the embodied self is a means of understanding stroke survivors' QOL during the first year of recovery, supporting an individualized and tailored rehabilitation practice.
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Affiliation(s)
- Synne G Pedersen
- Department of Rehabilitation, University Hospital of North Norway , Tromsø , Norway.,Department of Health and Care Sciences, Faculty of Health Sciences, UiT, the Arctic University of Norway , Tromsø , Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway , Tromsø , Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT, the Arctic University of Norway , Tromsø , Norway
| | - Lena Aadal
- Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University , Aarhus , Denmark
| | - Hanne Pallesen
- Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University , Aarhus , Denmark
| | - Siri Moe
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, the Arctic University of Norway , Tromsø , Norway
| | - Cathrine Arntzen
- Department of Rehabilitation, University Hospital of North Norway , Tromsø , Norway.,Department of Health and Care Sciences, Faculty of Health Sciences, UiT, the Arctic University of Norway , Tromsø , Norway
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Re-engaging with places: Understanding bio-geo-graphical disruption and flow in adult brain injury survivors. Soc Sci Med 2019; 231:22-30. [DOI: 10.1016/j.socscimed.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022]
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13
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Andrews GJ. Spinning, hurting, still, afraid: Living life spaces with Type I Chiari Malformation. Soc Sci Med 2019; 231:13-21. [DOI: 10.1016/j.socscimed.2018.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/04/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
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Maersk JL, Cutchin MP, la Cour K. Identity and home: Understanding the experience of people with advanced cancer. Health Place 2018; 51:11-18. [PMID: 29501690 DOI: 10.1016/j.healthplace.2018.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/31/2018] [Accepted: 02/09/2018] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to explore how the identity of people with advanced cancer is influenced by their experiences of living at home. A total of 28 in-depth interviews were conducted with 22 people with advanced cancer and four spouses. Grounded theory guided the collection and analysis of data. Home tours and associated field notes augmented the interview data. The analysis revealed that support of participants' identity was reflected in their abilities to live and occupy the home during daily activities, and in the ways the home and objects functioned as referents to themselves and their past. Threats to their identity ensued as the home environment became unmanageable during daily activities and as homecare professionals and assistive devices entered the home. By supporting people with advanced cancer in maintaining daily activities in the home and reducing changes in the home caused by homecare it is possible to reduce loss of identity.
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Affiliation(s)
- Jesper Larsen Maersk
- University of Southern Denmark, Research Unit of General Practice, Research Initiative for Activity Studies and Occupational Therapy, JB Winsloews vej 9, 5000 Odense C, Denmark; University College Absalon, Department of Occupational Therapy, Parkvej 190, 4700 Naestved, Denmark; The Social and Health Academy, Vestensborg Alle 78, 4800 Nykoebing Falster, Denmark.
| | - Malcolm P Cutchin
- Wayne State University, Department of Health Care Sciences, 259 Mack Ave., Detroit, MI 48201, United States.
| | - Karen la Cour
- University of Southern Denmark, Research Unit of General Practice, Research Initiative for Activity Studies and Occupational Therapy, JB Winsloews vej 9, 5000 Odense C, Denmark.
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Shin JH. Listen to the Elders: Design Guidelines for Affordable Multifamily Housing for the Elderly Based on Their Experiences. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/02763893.2018.1431585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jung-hye Shin
- Design Studies Department, University of Wisconsin–Madison, Madison, Wisconsin, USA
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16
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Mayo NE. Stroke Rehabilitation at Home: Lessons Learned and Ways Forward. Stroke 2016; 47:1685-91. [PMID: 27143275 DOI: 10.1161/strokeaha.116.011309] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/22/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Nancy E Mayo
- From the Division of Clinical Epidemiology, Department of Medicine, School of Physical and Occupational Therapy, Center for Outcomes Research and Evaluation, McGill University Health Center Research Institute, McGill University, Montreal, Québec, Canada.
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