Identity Continuity in the Face of Biographical Disruption: ‘It's the same me’ (original) (raw)
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Journal of Rehabilitation Medicine
Background: Rates of return-to-work after stroke are low, yet work is known to positively impact people’s wellbeing and overall health outcomes.Objective: To understand return-to-work trajectories, barriers encountered, and resources that may be used to better support participants during early recovery and rehabilitation.Participants: The experiences of 31 participants (aged 25–76 years) who had or had not returned to work after stroke were explored.Methods: Interview data were analysed using reflexive thematic analysis methods within a broader realist research approach.Results: Participants identified an early need to explore a changed and changing occupational identity within a range of affirming environments, thereby ascertaining their return-to-work options early after stroke. The results articulate resources participants identified as most important for their occupational explorations. Theme 1 provides an overview of opportunities participants found helpful when exploring work ...
Life interrupted and life regained? Coping with stroke at a young age
International journal of qualitative studies on health and well-being, 2014
Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients' life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an "altered sense of self," a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by...
Background and Purpose. Patient experience is increasingly being recognised as a key health outcome due to its positive correlation with quality of life and treatment compliance. The aim of this study was to create a model of how patient’s experiences of rehabilitation after stroke influence their outcome. Methods. A metaethnography of qualitative articles published since 2000 was undertaken. A systematic search of four databases using the keywords was competed. Original studies were included if at least 50% of their data from results was focused on stroke survivors experiences and if they reflected an overarching experience of stroke rehabilitation. Relevant papers were appraised for quality using the COREQ tool. Pata analysis as undertaken using traditional processes of extracting, interpreting, translating, and synthesizing the included studies. Results. Thirteen studies were included. Two themes (1) evolution of identity and (2) psychosocial constructs that influence experience were identified. Amodel of recovery was generated. Conclusion. The synthesis model conceptualizes how the recovery of stroke survivors’ sense of identity changes during rehabilitation illustrating changes and evolution over time. Positive experiences are shaped by key psychosocial concepts such as hope, social support, and rely on good self-efficacy which is influenced by both clinical staff and external support.
Vulnerability and Post-Stroke Experiences of Working-Age Survivors During Recovery
SAGE Open, 2015
Survivors who experience stroke of mild to moderate severity are typically discharged home quickly, with only minimal referral for rehabilitation follow-up or support to meet specific needs in recovery. Particular vulnerabilities of younger, higher functioning stroke survivors have received some recognition in international literature in recent years. This article reports on findings of a small Australian qualitative study focusing on recovery and return to work experiences of young higher functioning female stroke survivors, in particular exploring experiences of post-stroke vulnerability from participants’ own perspectives. Our research adds depth and nuance to this developing area of interest and research. Our findings include survivors’ reflections on the consequences of delayed diagnosis, the impacts of empowering and disempowering interactions with health care professionals, a general lack of access to psychosocial rehabilitation, and frustrations of financial hardship. Implic...
Objective: To investigate the meaning of acting with others, in different places over the course of 1 year post-stroke. Methods: Qualitative interviews with 9 persons, age range 42-61 years (7 persons with cerebrovascular accident and 2 with subarachnoidal haemorrhage) over the course of a year (i.e. 3, 6, 9 and 12 months) were analysed using a grounded theory approach. Results: Four categories were identified from the analysis of the participants' experiences during the year of rehabilitation: (i) not recognized as the person I am; (ii) the burden of burden; (iii) inspiration and belonging through acting with others; (iv) reality adjustment through acting with others. From these categories a core category emerged: a process of belonging for integration. Conclusion: The 4 categories identified suggest that belonging is integral to participation, which is viewed as the goal of rehabilitation.
Journal of Rehabilitation Medicine, 2010
To investigate the meaning of acting with others, in different places over the course of 1 year post-stroke. Methods: Qualitative interviews with 9 persons, age range 42-61 years (7 persons with cerebrovascular accident and 2 with subarachnoidal haemorrhage) over the course of a year (i.e. 3, 6, 9 and 12 months) were analysed using a grounded theory approach. Results: Four categories were identified from the analysis of the participants' experiences during the year of rehabilitation: (i) not recognized as the person I am; (ii) the burden of burden; (iii) inspiration and belonging through acting with others; (iv) reality adjustment through acting with others. From these categories a core category emerged: a process of belonging for integration. Conclusion: The 4 categories identified suggest that belonging is integral to participation, which is viewed as the goal of rehabilitation.
The impact of early stroke on identity: A discourse analytic study
Health:, 2010
Her research interests involve aspects of different chronic illnesses, and in particular the ways in which chronic illness, and its treatment, can affect the sufferer"s identity and relationships with others. She is also interested in wider issues of identity, well being and patient experience.
2014
Background: Extensive studies have documented the complex and comprehensive psychosocial consequences of stroke. Psychosocial difficulties significantly affect long-term functioning and quality of life. Many studies have explored psychosocial interventions to prevent or treat psychosocial problems, but most have found modest effects. This study evaluated, from the perspective of adult stroke survivors, (1) the content, structure and process and (2) experienced usefulness of a dialogue-based psychosocial nursing intervention in primary care aimed at promoting psychosocial health and wellbeing. Methods: This was part of a feasibility study guided by the UK MRC complex interventions framework. It consisted of dialogue-based encounters with trained health professionals during approximately the first year poststroke. It was tested in two formats; individual or group encounters. Inclusion criteria were: Acute stroke, above 18 y.o., sufficient physical and cognitive functioning to particip...
Journal of Occupational Science
The present study aims to explore occupational engagement during expected and unexpected transitions in life, as well as to understand how self-identity and meaning, situated in the context, is created and recreated through the daily occupations. We use case examples of children with disabilities, adults with acquired brain injury, older adults with stroke and people with serious somatic illness, undergoing rehabilitation. The cases are drawn from previously performed studies by each of the authors. In the present study, a secondary analysis of data was conducted based on an abductive approach and theories of self-identity and transaction, to illustrate how changes in everyday life occupations made sense. Three themes emerged that structure the discussion; Disruption of a former self, Pursuing normality, and Reconstructing daily occupations and routines. Our discussion illustrates how different life transitions can be demanding and how people, situated in the context, revise and create new meaning and self-identity through their occupations. This discussion is relevant to occupational science and occupational therapy as well as to health promotional work more generally.