Chinese elderly patients’ perceptions of their rehabilitation needs following a stroke
Stroke is the third leading cause of death and disability among Chinese elderly patients in Hong Kong and yet the rehabilitation needs of these patients are rarely explored. The aim of this study was to identify the rehabilitation needs of Chinese elderly patients following a stroke. The study adopted an ethnographic approach, information being gathered by the researcher through interviews with 15 key informants selected by purposive sampling. The perceptions of patients as to their own needs were sought at three stages of recovery — in the acute and rehabilitation settings and at 1 month following discharge.
Ethical approval was gained from the Chinese University Faculty of Medicine ethical committee and access agreed by the hospital authorities. Verbal approval was gained from the patients before each interview, following confirmation of the voluntary nature of participation and assurance of confidentiality and anonymity. The researcher’s role was also clearly stated.
Analysis of the interview data produced five categories of patient need at the three stages of recovery, namely informational, physical, psychological, social and spiritual. The most frequently stated, but largely unmet, need in all settings was the need for information, particularly information about the reasons for stroke and about the activities that promote recovery. In the acute and rehabilitation settings patients’ responses indicated a need to be respected as individuals, to be addressed by name and to be provided with privacy. Although the Barthel Index administered during interviews charted recovery at different rates, nurses did not always make links between the level of functional ability and the help needed with physical tasks. They also failed to recognize the relationship between physical and psychological needs and the equal importance of both in recovery from stroke. As Chinese elderly patients tend to take a passive role in seeking help and information, nurses play a significant role in the identification of individual rehabilitation needs. Implications for nursing practice are discussed.
"g . social consequences of stroke , couple counselling , and psychological support : " The major psychological support valued by the informants included giving them reassurance and a sense of security , offering verbal encouragement , listening to their worries , showing a caring attitude and respecting them as individuals " ( Lui , 1999 ) ( 32 ) . Only the participants in the Chinese study explicitly mentioned spiritual needs . "
[Show abstract][Hide abstract] ABSTRACT: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating this perspective.
A systematic review of qualitative studies was performed. A literature search in MEDLINE, CINAHL, PsycINFO, and EMBASE was conducted. Suitability for inclusion was based on selected criteria: published qualitative studies written in English from 1990 to 2008 on stroke survivors' experiences of rehabilitation in a clinical setting. Data analysis entailed extracting, editing, grouping, and abstracting findings.
Twelve studies were included. One theme, "Power and Empowerment" and six subcategories were identified: 1) Coping with a new situation, 2) Informational needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control.
The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual and relational aspects of power and empowerment. The capacity to assume power and empowerment was a dynamic rather than a progressive issue, and enabling empowerment was a matter of weighing contrasting issues against each other, e.g. the right to decide versus the right not to decide.
"After carefully reviewing the literatures in both the English and Chinese languages, we found very few published studies on the association of religious participation with mortality in Mainland China. Among these few studies, almost all were based on very small sample sizes in local communities and thus could not examine the effects of religious participation on mortality with reasonable statistical power (Holroyd 2002; Huang and Chao 1995; Lui and Mackenzie 1999; Wang and Wang 1998; Xi and Zhou 1996), except a recent article by Zhang (2008). Using data from the CLHLS baseline (1998) and the first follow-up (2000) waves, Zhang (2008) found that religious participation, coded simply as the presence or absence of religious involvement, was significantly associated with mortality among Chinese oldest-old women but not among Chinese oldest-old men. "
[Show abstract][Hide abstract] ABSTRACT: This research examines the association of religious participation with mortality using a longitudinal data set collected from 9,017 oldest-old aged 85+ and 6,956 younger elders aged 65 to 84 in China in 2002 and 2005 and hazard models. Results show that adjusted for demographics, family/social support, and health practices, risk of dying was 24% (p < 0.001) and 12% (p < 0.01) lower among frequent and infrequent religious participants than among nonparticipants for all elders aged 65+. After baseline health was adjusted, the corresponding risk of dying declined to 21% (p < 0.001) and 6% (not significant), respectively. The authors also conducted hazard models analysis for men versus women and for young-old versus oldest-old, respectively, adjusted for single-year age; the authors found that gender differentials of association of religious participation with mortality among all elderly aged 65+ were not significant; association among young-old men was significantly stronger than among oldest-old men, but no such significant young-old versus oldest-old differentials in women were found.
Research on Aging 01/2011; 33(1):51-83. DOI:10.1177/0164027510383584 · 1.23 Impact Factor
"Informanterna upplevde att sjuksköterskans arbete i huvudsak var inriktat mot de uppgifter som skulle utföras, och inte mot att se till patientens individuella behov. En del av informanterna uttryckte att de inte ville besvära personalen, och därför intog en passiv roll (Lui & Mackenzie, 1999). I en svensk studie (Röding m fl, 2003) var syftet att beskriva och analysera hur yngre stroke patienter upplevde rehabiliteringen och tiden efter en stroke. "
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