Article

Self-management is being increasingly promoted within chronic conditions
including stroke. Concerns have been raised regarding professional ownership of
some programmes, yet little is known of the professional's experience. This paper
aims to present the views of trained therapists about the utility of a specific
self-management approach in stroke rehabilitation. METHOD: Eleven stroke
therapists trained in the self-management approach participated in
semi-structured interviews. These were audio recorded, transcribed verbatim and
analysed thematically. RESULTS: Two overriding themes emerged. The first was the
sense that in normal practice therapists act as "benign dictators", committed to
help their patients, but most comfortable when they, the professional, are in
control. Following the adoption of the self-management approach therapists
challenged themselves to empower stroke survivors to take control of their own
recovery. However, therapists had to confront many internal and external
challenges in this transition of power resulting in the promotion of a somewhat
"reluctant democracy". CONCLUSIONS: This study illustrates that stroke therapists
desire a more participatory approach to rehabilitation. However, obstacles
challenged the successful delivery of this goal. If self-management is an
appropriate model to develop in post stroke pathways, then serious consideration
must be given to how and if these obstacles can be overcome. IMPLICATIONS FOR
REHABILITATION: Stroke therapists perceive that self-management is appropriate
for encouraging ownership of rehabilitation post stroke. Numerous obstacles were
identified as challenging the implementation of self-management post stroke.
These included: professional models, practices and expectations; institutional
demands and perceived wishes of stroke survivors. For self-management to be
effectively implemented by stroke therapists, these obstacles must be considered
and overcome. This should be as part of an integrated therapy service, rather
than as an add-on.

Langue : ANGLAIS