Stroke recovery and prevention barriers among young african-american men: potential avenues to reduce health disparities.
Stroke recovery and prevention barriers among young african-american men: potential avenues to reduce health disparities.
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DOI：
10.1310/tsr2105-432
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发表时间：
2014-09
影响因子：
2.2
通讯作者：
Sajatovic M
中科院分区：
文献类型：
--
作者：
Blixen C;Perzynski A;Cage J;Smyth K;Moore S;Sila C;Pundik S;Sajatovic M
第一次中风的非裔美国人(AA)更年轻，中风发生率是其他美国人的两倍，中风后并发症也更多。评估年轻再障男性及其护理伙伴(CP)对卒中后护理障碍的感知，以便为这一高危群体在卒中后护理方面可接受和有效的改善提供信息。10名社区居住的再生障碍性贫血中风幸存者和7名他们的护理伙伴(CP)参加了焦点小组和咨询委员会会议。幸存者在一年内有过中风或短暂性脑缺血发作，Barthel ADL指数为60。在焦点小组中，幸存者和CP使用半结构化访谈指南，确定了卒中后护理的自我感知障碍和促进者。会议记录的主题分析和不断比较的方法被用来产生主题。幸存者年龄从34岁到不等。巴特尔的平均年龄为95.5岁。CP均为AA级女性，年龄从49岁到61岁不等。CP有五个妻子，一个未婚夫和一个侄女。参与者列举了多个个人、社会和社会中风康复挑战。虽然高血压和吸烟的风险得到了承认，但压力、抑郁、创伤后应激障碍、愤怒/沮丧、个人身份变化以及难以像AA男性那样交流独特需求等问题被更频繁地注意到。促进者包括家庭支持、减轻压力和改变饮食。年轻的AA男性和他们的CP感知到中风后的多种护理障碍。生物降低风险教育可能不能涵盖AA卒中幸存者健康管理的所有显著方面。利用家庭和社区的优势，解决心理健康问题，并直接让患者与医疗团队接触，可能会改善护理管理。
African-Americans (AA) who experience a first time stroke are younger, and have double the stroke rate and more post-stroke complications than other Americans. To assess perceived post-stroke care barriers among younger AA men and their care partners (CPs) in order to inform development of acceptable and effective improvements in post-stroke care for this high-risk group. Ten community-dwelling AA stroke survivors and 7 of their care partners (CPs) participated in focus groups and advisory board meetings. Survivors had stroke or transient ischemic attack within one year and a Barthel ADL Index >60. In focus groups, using a semi-structured interview guide, survivors and CPs identified self-perceived barriers and facilitators to post-stroke care. Thematic analysis of session transcripts and the constant comparative method were used to generate themes. Survivor age ranged from 34 to 64. Mean Barthel was 95.5. CPs, all AA women, ranged in age from 49–61. CPs were 5 wives, a fianceé and a niece. Participants cited multiple personal, social, and societal stroke recovery challenges. While hypertension and smoking risks were acknowledged, stress, depression, PTSD, anger/frustration, personal identity change, and difficulty communicating unique needs as AA men were much more frequently noted. Facilitators included family support, stress reduction and dietary changes. Younger AA men and their CPs perceive multiple post-stroke care barriers. Biological risk reduction education may not capture all salient aspects of health management for AA stroke survivors. Leveraging family and community strengths, addressing psychological health, and directly engaging patients with healthcare teams may improve care management.