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Recovery following stroke: The role of self-management education

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  • Kendall, Elizabeth
  • Catalano, Tara
  • Kuipers, Pim
  • Posner, Natasha
  • Buys, Nicholas
  • Charker, Jill

Abstract

Current stroke rehabilitation tends to focus on the bio-medical course of disability, often responding to psychological and social issues only when they have been implicated in crises. Although this situation is costly, little evidence exists in relation to how psychological and social outcomes can be facilitated or how psychosocial decline can be prevented. In the area of adjustment following traumatic injury, there has been some suggestion that rehabilitation should focus on the expansion of resources, skills and self-efficacy as this will enable individuals to cope more effectively with their medical condition and circumstances. The current study was a longitudinal randomised controlled trial involving 100 people with stroke, 58 of whom were randomly allocated to an intervention based on the notion of psychosocial skill expansion. All were patients of a major hospital in Queensland, Australia. An existing self-management intervention (The Chronic Disease Self-Management Course, Lorig et al., 2001) was used to operationalise the concept of psychosocial skill expansion. The control group reported declines in functioning during the first year following stroke in the areas of family roles, activities of daily living, self-care and work productivity, that were not reported by the intervention group. Although the groups had reached similar levels by one year post-stroke, this intervention may have a protective function, presumably by improving capacity to manage the functional requirements of daily life. However, the intervention did not appear to have its impact through self-efficacy, as was expected, and failed to influence outcomes such as mood or social participation. Nevertheless, the intervention warrants further investigation, given that it appears to improve rehabilitation outcomes, at least in the short-term.

Suggested Citation

  • Kendall, Elizabeth & Catalano, Tara & Kuipers, Pim & Posner, Natasha & Buys, Nicholas & Charker, Jill, 2007. "Recovery following stroke: The role of self-management education," Social Science & Medicine, Elsevier, vol. 64(3), pages 735-746, February.
  • Handle: RePEc:eee:socmed:v:64:y:2007:i:3:p:735-746
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    References listed on IDEAS

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    1. Robinson, Ian, 1990. "Personal narratives, social careers and medical courses: Analysing life trajectories in autobiographies of people with multiple sclerosis," Social Science & Medicine, Elsevier, vol. 30(11), pages 1173-1186, January.
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    1. Stefania Fugazzaro & Monica Denti & Monia Allisen Accogli & Stefania Costi & Donatella Pagliacci & Simona Calugi & Enrica Cavalli & Mariangela Taricco & Roberta Bardelli & on behalf of Look after Your, 2021. "Self-Management in Stroke Survivors: Development and Implementation of the Look after Yourself (LAY) Intervention," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
    2. Tal Adamit & Jeffrey Shames & Debbie Rand, 2023. "Functional and Cognitive Occupational Therapy (FaC o T) Improves Self-Efficacy and Behavioral–Emotional Status of Individuals with Mild Stroke; Analysis of Secondary Outcomes," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    3. Gately, Claire & Rogers, Anne & Sanders, Caroline, 2007. "Re-thinking the relationship between long-term condition self-management education and the utilisation of health services," Social Science & Medicine, Elsevier, vol. 65(5), pages 934-945, September.
    4. Atkin, Karl & Stapley, Sally & Easton, Ava, 2010. "No one listens to me, nobody believes me: Self management and the experience of living with encephalitis," Social Science & Medicine, Elsevier, vol. 71(2), pages 386-393, July.
    5. Emma Carlstedt & Susanne Iwarsson & Agneta Ståhl & Hélène Pessah-Rasmussen & Eva Månsson Lexell, 2017. "BUS TRIPS—A Self-Management Program for People with Cognitive Impairments after Stroke," IJERPH, MDPI, vol. 14(11), pages 1-16, November.

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