Article

PURPOSE: To capture patients' relearning processes from regained function to
improvements in daily life after grip reconstructive surgery in tetraplegia.
SUBJECTS: Eleven people with tetraplegia who underwent grip reconstructive
surgery during February 2009 to March 2011. METHODS: Qualitative interviews were
conducted 7 to 17 months after surgery and analysed using grounded theory.
RESULTS: Determination to reach a higher level of independence was the core
concept to integrate regained function into daily life. There were 3 phases
identified; "Initiate activity training," "Establish hand control in daily
activities," and "Challenge dependence." Between the phases psychological stages
occurred, first; "a belief in improved ability", and later in the process;
"confidence in ability". The process to fully integrate regain function in daily
life was described as long and time-consuming. However, the participants claimed
it useful to do the skills training in their home environment, without long-term
in clinic rehabilitation. CONCLUSION: Relearning activities in daily life after a
grip reconstruction is a time-consuming and demanding process. It includes skills
training, mental strategies and psychological stages together with environmental
and social factors. Accordingly, rehabilitation after grip reconstruction in
tetraplegia should focus on both grip skills and psychological stages, to
encourage that patient's keep their determination and achieve greater
independence. Implications for Rehabilitation There is a stepwise process to
transform improved function into daily use. The most important factor to
transform improved function into daily use was motivation to reach a higher
independence. Other important factors were; skills training, use of individual
learning strategies, belief and confidence in personal ability, social and
environmental factors. There was a long and demanding process to fully transform
the improved function into daily use. The participants preferred to do activity
training in the specific environment, usually at home.

Langue : ANGLAIS