M Kirkevold1. 1. Institute of Nursing Science, University of Oslo, Post office box 1120 Blindern, N-0317 Oslo, Norway. marit.kirkevold@sykepleievit.uio.no
Abstract
PURPOSE: To describe the characteristics of the illness trajectory of stroke during the first year. METHOD: A qualitative, prospective case study design; repeated in-depth semi-structured interviews with nine mild to moderately affected stroke patients during the course of the first year. A total of 63 interviews were conducted. The interview data were transcribed verbatim and analysed as a text, using a hermeneutic approach. RESULTS: A stroke is not necessarily experienced as an abrupt psychosocial crisis by the stroke patient. The adjustment process seems to be gradually evolving and prolonged over most of the first year following the cerebro-vascular accident (CVA). The illness trajectory may be divided into four phases, each with characteristic tasks and focal points. The adjustment process involves hard physical and psychosocial work on the part of patient. A necessary pre-requisite for adjustment is a realistic conception of the illness and its implications. This takes time and experience to achieve. CONCLUSIONS: The adjustment process following stroke is gradual and prolonged. In order to move away from the predominant functional rehabilitation approach towards a more comprehensive and better targeted service, increased understanding of the complexities of the adjustment process is necessary.
PURPOSE: To describe the characteristics of the illness trajectory of stroke during the first year. METHOD: A qualitative, prospective case study design; repeated in-depth semi-structured interviews with nine mild to moderately affected strokepatients during the course of the first year. A total of 63 interviews were conducted. The interview data were transcribed verbatim and analysed as a text, using a hermeneutic approach. RESULTS:A stroke is not necessarily experienced as an abrupt psychosocial crisis by the strokepatient. The adjustment process seems to be gradually evolving and prolonged over most of the first year following the cerebro-vascular accident (CVA). The illness trajectory may be divided into four phases, each with characteristic tasks and focal points. The adjustment process involves hard physical and psychosocial work on the part of patient. A necessary pre-requisite for adjustment is a realistic conception of the illness and its implications. This takes time and experience to achieve. CONCLUSIONS: The adjustment process following stroke is gradual and prolonged. In order to move away from the predominant functional rehabilitation approach towards a more comprehensive and better targeted service, increased understanding of the complexities of the adjustment process is necessary.
Authors: Jennifer H White; Parker Magin; John Attia; Jonathan Sturm; Gregory Carter; Michael Pollack Journal: Ann Fam Med Date: 2012 Sep-Oct Impact factor: 5.166
Authors: Katie Gallacher; Deborah Morrison; Bhautesh Jani; Sara Macdonald; Carl R May; Victor M Montori; Patricia J Erwin; G David Batty; David T Eton; Peter Langhorne; Frances S Mair Journal: PLoS Med Date: 2013-06-25 Impact factor: 11.069
Authors: Katie Gallacher; Bhautesh Jani; Deborah Morrison; Sara Macdonald; David Blane; Patricia Erwin; Carl R May; Victor M Montori; David T Eton; Fiona Smith; G David Batty; David G Batty; Frances S Mair Journal: BMC Med Res Methodol Date: 2013-01-28 Impact factor: 4.615