What about self-management post-stroke? Challenges for stroke survivors, spouses and professionals

Abstract

Self-management post-stroke is challenging for many persons after a stroke. In this thesis is explored how stroke survivors, spouses and professionals perceived self-management post-stroke and how the process of self-management post-stroke evolved over time. The following studies are conducted: a thematic synthesis of qualitative studies, three focus group studies with stroke survivors, their spouses and professionals, and a longitudinal study among stroke survivors with participant observations and interviews. The process of self-management is a complex and dynamic process. Three phases can be distinguished: 1) Self-management of stroke consequences; 2) Self-management of daily activities; and 3) Selfmanagement of a meaningful life post-stroke. Stroke survivors, spouses and professionals all concluded that stroke survivors‘ self-management can best be developed durng the performance of daily activities at home. Furthermore, beside stroke survivors‘ self-management, there should also be attention for self-management of the spouses, co-management, and family management. Two types of stroke self-management programs are advised. In the first period post-discharge, the interventions should focus on development of stroke survivors’ self-management of everyday activities. The second type, recommended for stroke survivors who are at home for a longer time, should focus more on existential issues post-stroke and the possibiltiies stroke survivors (still) have to live a meaningful life.