脑卒中偏瘫患者对社会参与概念理解的质性研究
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摘要
目的建构脑卒中偏瘫患者对社会参与概念内涵的理解。方法 2017年9月—2018年6月,采用目的抽样的方法选取上海市某康复医院和某卒中随访门诊的12例脑卒中偏瘫患者为研究对象。采用半结构访谈的方法收集资料并录音,根据Colaizzi分析法对资料进行分析,提炼主题。结果脑卒中偏瘫患者对社会参与的理解可以归纳为3大主题7个亚主题,主题1:拥有自由之躯,即生活自理、活动自如;主题2:做有意义的事,即承担家庭责任、回到工作岗位、享受美好生活;主题3:与他人互动,即增加与他人的互动、减少与他人的互动。结论 3大主题体现出脑卒中偏瘫患者社会参与的独立性(Independent)、影响性(Influence)和互动性(Interaction),共同构成了社会参与的"3 I"模式。本研究有助于提高医务人员对社会参与的理解,为进一步研发脑卒中患者社会参与特异性测评工具提供理论依据。
Objective To construct the concept of social participation in stroke survivors with hemiplegia. Methods Twelve stroke survivors with hemiplegia in a rehabilitation hospital in Shanghai and a stroke follow-up clinic from September 2017 to June 2018 were selected by using purpose sampling method. Data were collected and recorded using semi-structured interviews, and analyzed through Colaizzi analysis to extract the theme. Results The understanding of social participation in patients with hemiplegia can be summarized into 3 themes and 7 subthemes, namely, having a body of freedom(self-care and freedom of movement), doing meaningful things(assuming family commitments, return to work, and enjoyment of a good life), and interacting with others(increased interaction and reduced interaction). Conclusion The extracted 3 themes of social participation reflect the independence, influence and interaction of stroke patients with hemiplegia, which together constitute the "3 I" model of social participation. This study provides a full understanding for social participation and a theoretical basis for further development of specific instruments of social participation for stroke patients.
Objective To construct the concept of social participation in stroke survivors with hemiplegia. Methods Twelve stroke survivors with hemiplegia in a rehabilitation hospital in Shanghai and a stroke follow-up clinic from September 2017 to June 2018 were selected by using purpose sampling method. Data were collected and recorded using semi-structured interviews, and analyzed through Colaizzi analysis to extract the theme. Results The understanding of social participation in patients with hemiplegia can be summarized into 3 themes and 7 subthemes, namely, having a body of freedom(self-care and freedom of movement), doing meaningful things(assuming family commitments, return to work, and enjoyment of a good life), and interacting with others(increased interaction and reduced interaction). Conclusion The extracted 3 themes of social participation reflect the independence, influence and interaction of stroke patients with hemiplegia, which together constitute the "3 I" model of social participation. This study provides a full understanding for social participation and a theoretical basis for further development of specific instruments of social participation for stroke patients.
引文
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[11]Erikson A,Park M,Tham K.Belonging:A Qualitative,Longitudinal Study of What Matters for Persons After Stroke During the One Year of Rehabilitation[J].J Rehabil Med,2010,42(9):831-838.DOI:10.2340/16501977-0608.
[12]H?ggstr?m A,Lund M L.The Complexity of Participation in Daily Life:A Qualitative Study of The Experiences of Persons with Acquired Brain Injury[J].J Rehabil Med,2008,40(2):89-95.DOI:10.2340/16501977-0138.
[13]Hammel J,Magasi S,Heinemann A,et al.What Does Participation Mean?An Insider Perspective from People with Disabilities[J].Disabil Rehabil,2008,30(19):1445-1460.DOI:10.1080/09638280701625534.
[14]周璇,唐秀花,周兰姝.社会参与概念的研究进展[J].中国康复医学杂志,2018,33(4):475-478.
[2]Levasseur M,Desrosiers J,St-Cyr Tribble D.Conceptual Comparison of the Disability Creation Process and International Classification of Functioning,Disability and Health Models[J].Can J Occup Ther,2007,74(ICFspecial issue):233-242.DOI:10.1177/000841740707405S02.
[3]姚巧灵,胡慧,郑桃云.护生对中医护理服务学习实践教学模式的真实体验[J].护理学报,2018,25(14):1-4.
[4]李铮,刘宇.护理学研究方法[M].北京:人民卫生出版社,2012:224-265.
[5]Nadeau S E,Wu S S,Dobkin B H,et al.Effects of Taskspecific and Impairment-based Training Compared with Usual Care on Functional Walking Ability After Inpatient Stroke Rehabilitation:LEAPS Trial[J].Neurorehabil Neural Repair,2013,27(4):370-380.DOI:10.1177/1545968313481284.
[6]Lord S E,McPherson K,McNaughton H K,et al.Community Ambulation After Stroke:How Important and Obtainable Is It and What Measures Appear Predictive?[J].Arch Phys Med Rehabil,2004,85(2):234-239.DOI:10.1016/j.apmr.2003.05.002.
[7]Griffith L E,Raina P,Levasseur M,et al.Functional Disability and Social Participation Restriction Associated with Chronic Conditions in Middle-aged and Older Adults[J].JEpidemiol Community Health,2017,71(4):381-389.DOI:10.1136/jech-2016-207982.
[8]Pallesen H.Body,Coping and Self-identity.A Qualitative5-Year Follow-Up Study of Stroke[J].Disabil Rehabil,2014,36(3):232-241.DOI:10.3109/09638288.2013.788217.
[9]夏征农,陈至立.辞海[M].上海:上海辞书出版社,2009.
[10]Zhang L,Yan T,You L,et al.Social Isolation and Physical Barriers in the Houses of Stroke Survivors in Rural China[J].Arch Phys Med Rehabil,2016,97(12):2054-2060.DOI:10.1016/j.apmr.2016.07.007.
[11]Erikson A,Park M,Tham K.Belonging:A Qualitative,Longitudinal Study of What Matters for Persons After Stroke During the One Year of Rehabilitation[J].J Rehabil Med,2010,42(9):831-838.DOI:10.2340/16501977-0608.
[12]H?ggstr?m A,Lund M L.The Complexity of Participation in Daily Life:A Qualitative Study of The Experiences of Persons with Acquired Brain Injury[J].J Rehabil Med,2008,40(2):89-95.DOI:10.2340/16501977-0138.
[13]Hammel J,Magasi S,Heinemann A,et al.What Does Participation Mean?An Insider Perspective from People with Disabilities[J].Disabil Rehabil,2008,30(19):1445-1460.DOI:10.1080/09638280701625534.
[14]周璇,唐秀花,周兰姝.社会参与概念的研究进展[J].中国康复医学杂志,2018,33(4):475-478.