Perceived participation and autonomy post‐stroke and associated factors: An explorative cross‐sectional study. (29th November 2020)

• Record Type: Journal Article
• Authors: Li, Yuxia; Zhang, Wei; Ye, Mingming; Zhou, Lanshu
• Is Part Of: Journal of advanced nursing. Volume 77:Number 3(2021)
• Page Start: 1293
• Page End: 1303
• Publication Date: 2020-11-29
• Subjects: autonomy -- coping -- self‐efficacy -- social participation -- social support -- stroke; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14670
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aims: To explore the level and associated factors of perceived participation and autonomy among stroke survivors in Shanghai, China. Design: Cross‐sectional explorative study. Methods: From January to December 2018, 431 patients presenting at the neurology departments of three hospitals with a confirmed diagnosis of stroke were recruited. Impact on Participation and Autonomy Questionnaire, modified Rankin Scale, Self‐efficacy for Managing Chronic Disease six‐item Scale, Medical Coping Modes Questionnaire and Multidimensional Scale of Perceived Social Support were applied to measure their participation, physical function, self‐efficacy, coping styles, and social support. Results: The average score of perceived participation and autonomy was 41.30 ( SD 21.22); and 54.3%, 46.9%, 21.6%, and 7.7% of the participants reported poor participation in social relations, family role, autonomy indoors, and autonomy outdoors. Age, physical function, self‐efficacy, friend support, and knowledge of stroke were predictors of post‐stroke participation. Physical function and self‐efficacy were the most relevant factors of nearly all domains of participation except autonomy outdoors, while predictors of autonomy outdoors were social support, resignation coping style, and knowledge of stroke. Conclusion: The stroke patients experienced insufficient participation compared with previous studies in western countries. Patients' physical function and self‐efficacy were particularly important and contributed to their participation, while the patient's age, perceived social support, coping styles, and knowledge of stroke also played a role in formulating participation. Impact: The results may be used to provide nurses with a better understanding of the participation among stroke patients and assist them in promoting the post‐stroke participation. Nurses should pay special attention to those with older age, worse physical function, lower self‐efficacy, less support, little stroke‐related knowledge, or who applied resignation coping style since those patients might experience lower participation in their daily life. It needs further studies to explore the causal effects of self‐efficacy, coping styles, and social support on post‐stroke participation. 摘要: 目的: 探讨中国上海市中风患者认知参与、自主性水平及相关因素。 设计: 横断面探索性研究。 方法: 2018年1月至12月, 共计招募431名在三家医院神经内科就诊并确诊为中风的患者。研究时, 采用参与和自主性测评问卷、改良兰金量表、慢性病管理的自我效能量表、医学应对方式问卷和多维度领悟社会支持量表, 对患者的参与、身体功能、自我效能、应对方式和社会支持等进行测量。 结果: 参与和自主性的均分为41.30( SD 21.22) ; 其中, 54.3%、46.9%、21.6%和7.7%的参与者分别在社会关系参与、家庭角色、室内自主和室外自主方面表现较差。中风后参与的预测因素包括年龄、身体机能、自我效能、朋友支持和中风知识。身体功能和自我效能感是参与领域中, 除户外自主活动外的最相关因素, 而户外自主活动的预测因素包括社会支持、顺从应对方式和中风知识。 结论: 相较于西方国家的早期研究, 中风患者的参与度较低。患者的身体功能和自我效能对其参与度有极大影响, 此外, 患者的年龄、所感知的社会支持、应对方式和对中风的认识同样可能导致其参与度变化。 影响: 根据研究结果, 护士可以更好地了解中风患者的参与情况, 并可推动中风患者参与。护士应尤其关注年龄较大、身体机能较差、自我效能较低、所获得的支持较少、中风相关知识掌握较少或已辞职的患者, 原因在于, 此类患者在日常生活中的参与度较低。应针对自我效能、应对方式和中风后参与的社会支持的因果影响等展开进一步研究。