Background
Methods
Study design
Participants and context
No. participant sex - year of birth | Diagnosis | Living conditions | Housing | Employment status | Leisure activities pre-stroke | (Dis)Abilities post-stroke after discharge |
---|---|---|---|---|---|---|
1 F - 1935 | RCVA | Married No children | House Service flat, 1 year post-stroke | No paid job | Cycling, creating postcards, baking, physio fitness, reading, holidays | Walking with rollator outside house Decreased coordination left arm/hand—fatigue |
2 M - 1958 | LCVA | Married Children living away from home | House | Long-term disability | Doing odd jobs and woodwork in garden, computer, visiting antique markets with wife, walking | Walking without devices Decreased coordination right arm/hand—fatigue |
3 F - 1942 | RCVA | Widow Children living away from home | House Flat, 1½ year post-stroke | Retired pre-stroke | Playing cards, social activities with friends, activities of elderly association, aqua jogging | Walking with rollator outside house Decreased coordination left arm/hand—fatigue |
4 M - 1946 | RCVA | Married Children living away from home | Flat | Stopped working post-stroke | Visiting friends and family, attending soccer | Wheelchair inside house; mobility scooter outside Spastic left arm |
5 F - 1946 | RCVA | Living together with partner Children living away from home | Flat | Stopped working post-stroke | Creating postcards, playing badminton, playing saxophone, physio fitness | Walking with rollator outside house Decreased coordination left arm/hand Decreased concentration and attention—fatigue |
6 M - 1951 | RCVA | Living together with partner Children living away from home | Flat | Reintegrated in new job post-stroke | Visiting cultural activities, referee in rugby, position in board care institution, jogging | Wheelchair inside house; mobility scooter outside Walking few meters—paralysed left arm |
7 F - 1948 | LCVA | Widow Children living away from home | Service flat | Retired pre-stroke | Cycling, voluntary work (primary school) | Walking with rollator in and outside house Decreased concentration |
8 F - 1946 | LCVA | Married Children living away from home | Flat | Retired pre-stroke | Walking, visiting theatre and museums, tennis, baby-sitting grandchildren | Walking with rollator in and outside Wheelchair, mobility scooter and adapted bicycle outside Hemiparesis right arm—moderate fatigue Moderate attention in groups of people |
9 F - 1957 | RCVA | Widow Son and daughter living at home | House | Reintegrated post-stroke Stopped working 1 year post-stroke | Visiting friends, church, singing in choir | Walking, cycling and car driving without devices Moderate fatigue Decreased processing of visual and auditive stimuli |
10 M - 1945 | RCVA | Living together with partner Children living away from home | House | Retired pre-stroke | Gardening, horse riding, cycling, doing odd jobs | Walking with stick few meters in and outside Wheelchair and mobility scooter outside Hemiparesis left arm |
Data generation
Participant | Observed activities and situations |
---|---|
1 | Baking a cake Doing the laundry Walking to the pharmacist and shopping Showing new apartment, preparing and drinking tea Walking in environment of new apartment Making postcards Preparing and drinking tea with participant and spouse |
2 | Preparing and drinking tea; woodworking in garden Joining occupational therapy session: exercises handwriting and woodwork Walking to garage and show repaired cars Walking in neighbourhood and drinking tea |
3 | Coffee, showing garden Preparing and having lunch at home Working in garden Preparing soup and having lunch at home Preparing and drinking coffee with pastry with participant |
4 | Drinking coffee with both spouses Showing pictures of jobs in past on computer Driving mobility scooter into park Visiting and training local soccer team Driving towards and shopping in builder’s store Showing new car with adaptations |
5 | Drinking tea with both spouses Making shopping list and shopping in supermarket Joining physiotherapy session Showing how to make postcards and making tea Touring in surroundings with mobility scooter Preparing and drinking tea with participant and spouse |
6 | Preparing and drinking coffee Using wheelchair to get to city centre and shopping Going to market with mobility scooter Showing adaptations and activities in kitchen Visiting and touring at new workplace Preparing and drinking tea ‘Walking and talking’ in environment in wheelchair |
7 | Preparing and drinking coffee Shopping in supermarket Having lunch in lunchroom in city Walking and talking, and showing car Performing little household activities, drinking tea with participant |
8 | Preparing and serving tea, coffee and cookies Folding laundry Preparing coffee and drinking coffee with participant and spouse Walking to garage and showing adapted bicycle |
9 | Visiting physiotherapy session Walking to and shopping in supermarket Preparing and having dinner with family Cycling in surroundings Driving with car to city Joining neuro-feedback therapy session |
10 | Preparing and drinking tea with participant and partner Showing garden and explaining activities pre-stroke Preparing and drinking tea with participant Trying out home trainer (cycle) |
• Self-management of participants • Performance of daily activities • Problem solving • Use of strategies • Roles | • Decision making • Support or help of others • Interaction with environment • Changes compared with previous point-of-data generation |
Introduction |
Conversation with reflective questions about the activities the participants has done prior to the interview. After the conversation about the activities, the conversation continues with introductory, key, probing and reflective questions about self-management and related topics in different situation in the past 3, 6, 9, 15 and 21 months at home. - You are now at home for 3-6-9-15-21 months. What did you do in your everyday life in the past months? How did it go? How do you manage the different situations in your everyday life? How do you feel about that? Depending on the answer of the participants, probing question will be asked about: Self-management of participants, performance of daily activities, problem solving, use of strategies, roles, decision making, support or help of others, interaction with environment. - Roles: People often have roles, for example, in their family, social network or at work. A role is, for example, being a father, worker, partner, friend, etc. What kind of roles do you have at the moment? How do you feel about that? Depending on the answer of the participants, probing question will be asked about: self-management of participants, performance of daily activities, problem solving, use of strategies, decision making, support or help of others, interaction with environment. - Interaction with and support of others: Some people need others to manage a situation or they manage it themselves. How is that for you, are you managing yourself alone or together with people in your environment? How do you interact with the people around you? How do you feel about that? Depending on the answer of the participants, probing question will be asked about: self-management of participants, performance of daily activities, problem solving, use of strategies, roles, decision making. - Changes: You are now at home for 6-9-15-21 months. If you compare how you managed yourself 3–6 months ago with the manner in which you manage yourself currently, do you see any differences? How do you feel about that? Depending on the answer of the participants, probing question will be asked about: Self-management of participants, performance of daily activities, problem solving, use of strategies, roles, decision making, support or help of others, interaction with environment. - Learning: What did you learn about the way you can manage yourself in your everyday life? Depending on the answer of the participants, probing question will be asked about: self-management of participants, performance of daily activities, problem solving, use of strategies, roles, decision making, support or help of others, interaction with environment. - Self-management:
o How do you manage yourself? Your everyday activities? Your life?o What helps you to manage yourself? Do you have ‘your own way’ (strategies) to manage yourself?o Are there examples of situations that limit you to manage yourself?o What have you learnt in the past months when you think about your own self-management?o Self-management often means that people make choices before or during they do something. How do you make your choices? Are there some changes in the way you make your choices? Are you taking these decisions yourself?o If you are asked to give advice to fellow stroke survivors, what kind of advice would you give them in regard to self-management? Depending on the answer of the participants, probing and reflective question about the different topics and possible changes. Summary of the conversation and ending questions: enable participants to reflect back on previous comments and make sure that nothing was overlooked. Closing of interview |