Survival, momentum, and things that make me "me'': patients' perceptions of goal setting after stroke
Survival, momentum, and things that make me "me'': patients' perceptions of goal setting after stroke
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DOI：
10.3109/09638288.2013.825653
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发表时间：
2014-01-01
影响因子：
2.2
通讯作者：
Taylor, William J.
中科院分区：
文献类型：
--
作者：
Brown, Melanie;Levack, William;Taylor, William J.
目的：目标设定和以患者为中心被认为是康复的基本概念。然而，让患者参与设定目标的最佳方式仍不清楚。本研究的目的是探讨患者在急性中风后康复中设定目标的经历，以进一步了解其在实践中的应用。方法：使用主题分析来分析 10 名中风幸存者的访谈记录，这些幸存者是从 4 个康复单位招募的，作为一项试点研究的一部分，该研究调查了结构化方法在急性中风后康复中引发以患者为中心的目标的效果。结果：出现了三个关键主题：（1）“日复一日的动力”，包括“不可预测性”和“自然进步”的从属主题，其中每天的进步被视为康复的一个组成部分； （2）“战与盟”，斗争与支持的问题影响参与者的进步； (3)“特别的事情”，由“什么使我成为我”和“象征性成就”这两个从属主题组成，涉及定义个人及其康复经历的问题。结论：患者围绕目标设定的讨论可能与临床医生在描述康复目标设定中的“最佳实践”时通常使用的讨论不同。了解患者对目标的非常规看法可能有助于支持和激励他们，从而为他们的康复提供动力。
Purpose: Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. Method: Thematic analysis was used to analyse interview transcripts from 10 stroke survivors, recruited from 4 rehabilitation units as part of a pilot study investigating the effects of a structured means of eliciting patient-centred goals in post-acute stroke rehabilitation. Results: Three key themes emerged: (1) ``A Day by Day Momentum'', comprising subordinate themes of ``Unpredictability'' and ``Natural Progression'' in which daily progress forwards was seen as an integral part of rehabilitation; (2) ``Battle versus Alliance'' in which issues of struggle versus support influenced participants' advancement; and (3) ``The Special Things'', consisting of subordinate themes of ``What Makes Me ` Me''' and ``Symbolic Achievements'' concerning issues defining individuals and their rehabilitation experiences. Conclusions: Patients' discourse around goal setting can differ from the discourse conventionally used by clinicians when describing ``best practice'' in rehabilitation goal setting. Understanding patients' non-conventional views of goals may assist in supporting and motivating them, thus providing drive for their rehabilitation.