Stroke is a public health concern throughout the world due to its association with high levels of mortality and long-term morbidity. Stroke is a chronic condition. There is evidence that the use of self-management strategies can be associated with positive outcomes for people with chronic conditions. The evidence relating to stroke and self-management informs stroke policies in the UK. However, there is minimal understanding of self-management in the context of stroke. Rehabilitation interventions which can adequately address the longer term needs require an understanding of key factors which may influence self-management in stroke survivors. The overall aim of the research presented in this thesis was to explore the concept of self-management in the context of stroke. This thesis presents a mixed methods study that was designed to address three specific and connected research questions. This thesis described three studies. Firstly, through a systematic review of qualitative studies with thematic synthesis it systematically examined the current literature to determine stroke survivors' experiences of living with stroke and the biopsychosocial factors that may influence these experiences of post-stroke life as well as the components of these factors that might be relevant to self-management. Secondly, through a prospective quantitative cohort study, it investigated the biopsychosocial individual characteristics associated with self-management and self-efficacy in adults with stroke. Finally, through a qualitative interview study, it explored the meaning(s) ascribed to "self-management" by stroke survivors and healthcare professionals. The key findings taken together reveal new insights into the psychosocial phenomena that shape coping and adjustment after stroke; the biopsychosocial factors that influence selfmanagement and self-efficacy; and the conceptualisations of self-management. This thesis therefore develops new understandings of self-management in the context of stroke. Findings have implications for formulation, organization and delivery of better aftercare and the rehabilitation that follows.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:616980 |
| Date | January 2013 |
| Creators | Kahraman, Ayfer |
| Publisher | St George's, University of London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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