“HOW I HELP MYSELF”: SELF-MANAGEMENT STRATEGIES EMPLOYED BY PERSONS WITH A STROKE

Rhoda A.¹, Smith J.¹, Joseph C.^1,2

¹University of the Western Cape, Physiotherapy, Bellville, South Africa, ²Karolinska Institute, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden

Background: Self-management, which is based on self-efficacy principles, has been found to have a positive effect on quality of life. Self-management which involves the active participation of the patient and in some cases their family in the management of their condition, is especially important in low to middle income countries as it lessens the burden on the healthcare system. Before employing self management as an adjunct to rehabilitation of persons with a stroke in low-resourced areas, it is important to explore the individuals' experiences of being capable of managing their condition and to identify and characterize self-management strategies employed to date.

Purpose: To explore the lived experiences of persons with a stroke in low-resourced areas of South Africa in managing their health condition in order to inform self-management principles and strategies during rehabilitation.

Methods: A phenomenological, qualitative study was used to explore the self-management strategies employed. Interviews were conducted with 10 purposively selected individuals, who were able to share their experiences of living with a stroke as well as the strategies they employed to assist with functioning in their homes and communities. The data were collected from persons with stroke living in the community. The interviews which were conducted in the participants’ homes, lasted for approximately 45 minutes, and were audio-taped. Inductive thematic analysis was used to analyse the data and ethical clearance was obtained from the University of the Western Cape’s Senate Ethics Committee. To ensure transferability of the findings, a broad description of important aspects of the study, such as the setting and participants was provided, while an audit trail of the conceptualization of the study, participant recruitment and analysis processes was included to ensure dependability and confirmability.

Results: In exploration of the phenomenon of the lived experiences of self-management strategies employed by persons with a stroke to restore meaning and functioning, four main themes emerged. These were adaptation, engaging with information provided, self-efficacy and spirituality. The participants expressed how they adapted to facilitate: improved function, continued engagement in leisure activities and lack of finances. The manner in which the participants engaged with the information pertaining to dealing with and handling their condition was also expressed. The participants expressed how their belief in their abilities motivated them to engage in functional and social activities. Additionally, participants expressed their dependability on a higher being for recovery.

Conclusion(s): To function within the community, stroke survivors implement adaptive behaviors, engage with information provided to them and rely on themselves and a higher power for assistance. The role of spirituality in the the rehabilitation of stroke patients needs to be explored further.

Implications: Physical therapy for individuals with stroke should therefore provide these individuals with principles to adapt their environment and information to facilitate their functioning in the communities. Physical therapist should also engage aspects relating to self-efficacy and spirituality which could enhance self-belief and resilience.

Funding acknowledgements: National Research Foundation of South Africa

Topic: Professional issues

Ethics approval: Ethics approval was obtained from the University of the Western Cape´s Senate Ethics Committee.

All authors, affiliations and abstracts have been published as submitted.