Kotona asuvan aivoverenkiertohäiriöpotilaan ja hänen omaisensa kokemuksia selviytymisestä
1University of Oulu, Faculty of Medicine, Department of Nursing Science
2Oulu University Hospital, Unit of Medical Rehabilitation
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|Persistent link:|| http://urn.fi/urn:isbn:9514255550
|Publish Date:|| 2000-02-18
|Thesis type:||Doctoral Dissertation
|Defence Note:||Esitetään Oulun yliopiston lääketieteellisen tiedekunnan suostumuksella julkisesti tarkastettavaksi Oulun Diakoniaopiston auditoriossa (Uusikatu 46), 10. maaliskuuta 2000 klo 12.
Professor Sirkka-Liisa Ekman
Docent Eeva Leino
The purpose of the study was to describe the experiences of home-dwelling stroke patients and their relatives about coping and to identify possible similarities and differences in these experiences. The research data were collected by interviewing 18 stroke patients and 20 relatives. The data were analysed using the phenomenological method.
Based on the data, the stroke patients were divided into six groups with different coping strategies: flexible coping, realistic adjustment, recollection of losses, aspiration to work, denial of illness and submission to problems. Persons showing flexible coping live a full life. Meaningful activities and interpersonal relations promote coping, while problems due to the illness impair it. Persons showing realistic adjustment have modified their life styles to suit their resources. Coping is promoted by satisfaction with life and impaired by incidental periods of lack of energy. Persons who prefer to recollect losses draw energy from their past lives. Coping is promoted by interpersonal rehabilitation and impaired by a lack of meaningful activities. Persons showing aspiration to work seek for meaningful activities similar to salaried employment. Coping is promoted by humour and impaired by a lack of activity. Persons showing denial of illness attribute their problems to causes other than the disorder in brain circulation. Coping is promoted by stability of life and impaired by a fear of changes. Persons showing submission to problems tend to dwell on the losses due to their illness. Coping is promoted by contacts with children and impaired by depression.
The relatives showed five coping strategies: re-orientation, confidence, escape, persistence and abandonment. Persons showing re-orientation had modified their strategies to be compatible with their life situation. Coping is promoted by hobbies and social relations and impaired by a lack of connections between rehabilitation and home life. Persons showing confidence see both good and bad points in their life situation. The need to re-consider one's life values is good, while the need to give up plans for the future is bad. People who escape tend to live either in the past or in the future. Coping is promoted by the learning of new roles and impaired by living on the patient's condition. Persistence is shown by people who only modify their strategies when forced to do so. Coping is promoted by planning of the future and impaired by disappointments at the medical and nursing personnel and the rehabilitation system. People who show abandonment are dissatisfied with their life situation. They have few chances to alter the situation and often have poor health.
The patients' and relatives' experiences showed both similarities and differences. The patients and relatives had similar experiences of their own situation, treatment and rehabilitation, interpersonal relations and expectations, but the patients had more fears about their life situation than the relatives, while the relatives felt more responsibility for the coping at home. The patients' experiences generally focused on themselves, while the relatives' experiences were more abstract and encompassing. The patients and relatives who coped poorly felt that their whole life was filled by the illness, while for those who coped well it was only one experience among the others. The coping strategies of a patient and a relative who lived in the same household were mutually interdependent, and should therefore be viewed together.
The findings may help us to understand the everyday home life of stroke patients and their relatives. They can be utilised while developing the nursing practice and rehabilitation.
Acta Universitatis Ouluensis. D, Medica
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