| 1. |
- Dalvandi, Asghar, et al.
(författare)
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Everyday Life Condition in Stroke Survivors and Their Family Caregivers in Iranian Context
- 2013
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Ingår i: International Journal of Community Based Nursing & Midwifery. - Tehran. - 2322-2476. ; 1:1, s. 3-15
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStroke is an unexpected major life incident that effect on physical functioning and can lead tochanges in lifestyle and inability to manage self care, work or leisure. To explore the everydaylife situation as experienced by stroke survivors, and their family caregivers, this study wasconducted 3-6 month after stroke.MethodsTwelve stroke survivors and thirteen family caregivers were interviewed and a qualitativecontent analysis was conducted to analyze data.ResultsThe results were categorized into two central themes that were identified as; (1) Being challengedby changes in everyday life situation including; the struggle with physical dysfunctions,inappropriate daily plan for leisure activities, changes in mood, being faced with economicalproblems and being worried about changing roles (2) striving to cope with new conditionsincluding; trying to preserve self-worth, seeking to support from spirituality, learning andre-learning and regaining independency.ConclusionPhysical dysfunction was the major concern for both the survivors and their family caregiversin their everyday life situation. This problem led to, and forced them, to be dependent on others.Training is needed to teach stroke survivors and their families strategies of how to cope withand overcome ongoing challenges of everyday life after stroke and to re-organize their livesand improve skills of the survivors to deal with the new situation at home.A daily plan for spending their time and leisure activities would ease this work. Moreinvestigation will be needed to clarify the process of life after stroke to cover this gap.
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| 2. |
- Dalvandi, Asghar
(författare)
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Exploring life after stroke : experiences of stroke survivors, their family caregivers and experts in an Iranian context
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The global burden of stroke is immense. Despite the high incidence of stroke, little research has been done on the post stroke recovery process. Aim; the overall aim of this research project was to explore life after stroke based on experiences of stroke survivors (I, II), their family care givers (I-III) and expert in field of rehabilitation (IV) in an Iranian context. Material and Method: Data for the studies were gathered from knowledgeable participants and followed to figure out the themes by purposeful selection (I-IV) and then by theoretical sampling (II-IV). Data were analyzed by the basic tenets of the grounded theory approach according to Strauss & Corbin, by semi-structured interviews and focus group discussions (II-III-IV) and qualitative content analysis (I). Results: In Study (I) the results were categorized into the two main themes that were identified as; (1) challenged by changes in life situations and (2) striving to cope with new conditions. Study (II) identified “functional disturbances” as core concept. Functional disturbances were encompassed by in appropriate strategies in managing and supporting, such as lack of adequate social insurance and access to the few existing rehabilitation services. In study (III) the core concept identified was “lack of continuity of rehabilitation care”. Seven related main categories were extracted including inadequate knowledge and skills, inappropriate accessibility to rehabilitative services, inadequate social insurances, modifying home environment, managing coexisting medical conditions, improving nurses’ roles and, relying on family unity. In study (IV) “non-integrated rehabilitation service” emerged as core concept. The explored concepts were ‘deficiently allocated budget’, ‘inadequate social insurance’, ‘lack of availability of rehabilitative care’, ‘negative public opinions’, ‘lack of consistency of care’, ‘split services and professional separation’. Potential areas for improvements were ‘need for changing policymakers’ attitudes’, ‘needs for refining rehabilitation in health care system’, ‘needs for establishing a registration system’, ‘needs for providing information and skills’ and ‘needs for seeing the family as a whole’. In conclusion, the core concept for life after stroke was “functional disturbances”. Non-integrated rehabilitation services within health care system and lack of continuity of rehabilitation care caused stroke survivors and their family caregivers to experience ranges of dysfunctions in terms of physical, emotional, psychological and social aspects. Change of policy makers’ attitude appears to be important in order to allocate adequate budget in this regards. Stroke survivors and their family caregivers experienced everyday life in terms of being challenged by changes in life situation and striving to cope with new conditions. The study results indicate that focusing on multidisciplinary approach and establishing registration system for follow-up of survivor’s rehabilitation are to be recommended.
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| 3. |
- Dalvandi, Asghar, et al.
(författare)
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Lack of continuity of rehabilitation care for stroke survivors : Iranian family caregivers' experience
- 2011
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Ingår i: Middle East Journal of Age and Aging. - 1449-8677. ; 8:4, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objective: Stroke is a common disabling disorder that requires the involvement of family caregivers to successfully encourage the patient's rehabilitation. This is especially true in Iran, where the family members commonly have the main responsibility of care of disabled persons. The aim of this study was to explore the Iranian family caregivers' experience of providing rehabilitation care at home. Method: A grounded theory approach and the main tenets of constant comparative method were used. Twelve participants were interviewed using semi-structured in-depth interviews. Findings: The core concept was identified as "lack of continuity of rehabilitation care". Seven main categories were identified. Three of them were related to the problems family caregivers faced, including inadequate knowledge and skills, inappropriate accessibility to rehabilitative services, and inadequate social insurance. Four categories were about the strategies that family caregivers used to deal with the major concerns; modifying home environment, managing coexisting medical conditions, improving nurses' roles and, relying on family unity. Conclusion: Family caregivers need continuity of rehabilitative care besides their family engagement, to enable access to care. They also need support from adequate social insurance and increased access to rehabilitation care. Undergoing rehabilitation at home gives people the advantage of practicing skills and developing compensatory strategies in the context of their own living environment by training and helping family caregivers and stroke survivors in terms of modifying home environment and managing coexisting medical conditions. Here, nurses can have an important role by helping the family caregivers with education and training.
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| 4. |
- Dalvandi, Asghar, et al.
(författare)
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Life experiences after stroke among Iranian stroke survivors
- 2010
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Ingår i: International Nursing Review. - : Wiley. - 0020-8132 .- 1466-7657. ; 57, s. 247-253
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke is a major cause of disability worldwide. It is a life-threatening and life-altering event, which leaves many physical and mental disabilities, thus creating major social and economic burdens. Experiencing a stroke and its aftermath can be devastating for patients and their families. In Iran, many services are not available for those who lack property; this may result in many difficulties and long-term problems for stroke survivors and their family members who are usually the main caregivers in Iranian cultural. Despite its effect on their lives, little is known about how the survivors perceive stroke in the Iranian context, therefore, knowing more about this process may enhance problem identification and problem solving.Aim: To illuminate how stroke survivors experience and perceive life after stroke.Method: A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors.Findings: The survivors perceived that inadequate social and financial support, lack of an educational plan, lack of access to rehabilitative services, physical and psychological problems led them to functional disturbances, poor socio-economical situation and life disintegration. The core concept of life after stroke was functional disturbances.Conclusions: The study shows the need to support the stroke survivors in their coping process with their new situation by providing appropriate discharge plans, social and financial support, social insurances and training programmes for the stroke survivors and their families.
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| 5. |
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| 6. |
- Dalvandi, Asghar, et al.
(författare)
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Rehabilitation Experts' Experience of Community Rehabilitation Services for Stroke Survivors in Iran
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 19:5, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Successful stroke rehabilitation is a complex process involving teamwork by members of several professions. The aims of this study were to explore the experiences of Iranian rehabilitationexperts concerning community rehabilitation services for stroke survivors and obtain their opinions on how to further develop and improve these services. Method: A qualitative research method with grounded theory was used, including purposive and theoretical sampling. A constant comparative analysis was conducted. Data were gathered from 2 focus group discussions including 10 Iranian rehabilitation experts and 4 in-depth individual interviews. Results: Nonintegrated rehabilitation services emerged as the core concept of the study. The explored concepts were identified as deficiently allocated budget, inadequate public insurance, lack of availability of rehabilitative care, negative public opinion, lack of consistency in care, and split services and professional separation. Areas identified for potential improvement included need to change policymakers' attitudes, need to refine rehabilitation in the health care system, need to establish a registration system, need to provide information and skills, and need to see the family as a whole. Conclusion: Experts should participate in educational rehabilitation programs to become more aware of current rehabilitationservices within the community. Stroke survivors and their families should also participate in the rehabilitation programs as this would allow them to gain knowledge and skills for dealing withstroke management. This can help reduce problems, change public opinion, and eliminate mistrust between health care providers and families.
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