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The meaning of rehabilitation for older people who have survived stroke
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
2009 (English)In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, Vol. 1, no 2, 186-195 p.Article in journal (Refereed) Published
Abstract [en]

Aim. To explore the meaning of rehabilitation to older, Swedish stroke survivors, from the time of the acute stroke to the end of the rehabilitation.

Background. Many people who are stroke survivors do not resume social activities even though they have regained physical functions. However, the contents of stroke rehabilitation seems to depend on whether rehabilitation is understood from the disease perspective or the illness perspective contained in the International Classification of Functioning, Disability and Health. This in turn may determine the kind of rehabilitation offered to survivors.

Design. Inductive, qualitative interview study undertaken during 2003.

Method. Nineteen Swedish stroke survivors were interviewed twice, and the interviews were analysed using a Grounded Theory approach.

Findings. To the older survivors, the meaning of rehabilitation was social reintegration. To achieve this they tried to regain lost physical and cognitive functions, relations (including play activities, everyday narratives and self-esteem) and lost certainty. The survivors needed to regain their ability to be not only to perform social activities. However, their rehabilitation ended when its focus turned to impairments found in the illness experiences of the survivors. The survivors developed their own cognitive and behavioural strategies for overcoming these kinds of obstacles to their social reintegration.

Conclusion. Older, Swedish stroke survivors strive for a socially integrated life. Unacknowledged impairments experienced from the illness perspective of the survivors and the survivors’ own rehabilitation strategies should therefore be considered in their rehabilitation.

Relevance to clinical practice. Stroke survivors need support from professionals who can understand and acknowledge the illness perspective of rehabilitation. Professionals should be able to understand how to facilitate the cognitive and behavioural strategies found in survivors’ illness narratives. In order to socially reintegrate, survivors’ rehabilitation should be transferred to the places where they have previously performed play activities together with family and friends.

Place, publisher, year, edition, pages
2009. Vol. 1, no 2, 186-195 p.
Keyword [en]
cerebrovascular, geriatrics, qualitative research, rehabilitation, stroke
National Category
Medical and Health Sciences
Research subject
Health Care Research
URN: urn:nbn:se:uu:diva-97534DOI: 10.1111/j.1752-9824.2009.01020.xOAI: oai:DiVA.org:uu-97534DiVA: diva2:172519
Available from: 2008-09-18 Created: 2008-09-18 Last updated: 2012-05-11Bibliographically approved
In thesis
1. Understanding Life After Stroke
Open this publication in new window or tab >>Understanding Life After Stroke
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stroke is an acute, neurological dysfunction of vascular origin with sudden occurrence and it influences physical, cognitive and psychological functions. Initial treatment aims at eliminating or reducing the brain damage. Soon, however, the influence of the stroke on the entire life of stroke survivors has to be considered.

This thesis explores the meaning of life after stroke to 19 elderly stroke survivors during the first year post stroke. Survivors were interviewed twice and the interviews were analysed through qualitative methods.

Study I was about four survivors who delayed hospital arrival far beyond time limits for trombolytic treatment. The survivors had a strong need for control of body, autonomy and integrity and they demanded to be encountered in consultations as a person by a person. To make them search for emergency evaluation in time might demand an emergency care treating them according to these needs.

In Study II the voice of an aphasic survivor was heard. Because of the damaged language his rehabilitation unilaterally focussed on language training and his need for comprehensive support and planning for the future was not observed. Implementation of a qualitative research method for text analysis adapted to practical use in dialogues with aphasic persons might ensure these survivors an adequate rehabilitation.

Study III showed how time models in narratives helped stroke survivors to overcome uncertainty and recreate narrative coherence in their lives. Professionals can support survivors through revealing and reinforcing the meaning of these models.

Study IV found that the meaning of rehabilitation to stroke survivors was social reintegration. Many probably did not socially reintegrate because their own strategies and subjectively experienced disabilities were unacknowledged in their rehabilitation. Through integrating illness-as-lived perspectives with biomedical perspectives, subjective dysfunctions and rehabilitation strategies of survivors could be acknowledged in stroke rehabilitation.

Place, publisher, year, edition, pages
Uppsala: Universitetsbiblioteket, 2008. 80 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 376
National Category
Clinical Science
urn:nbn:se:uu:diva-9278 (URN)978-91-554-7280-1 (ISBN)
Public defence
2008-10-10, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskölds väg 20, Uppsala, 09:15
Available from: 2008-09-18 Created: 2008-09-18Bibliographically approved

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