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INTRODUCTION. An ischemic stroke causes disfunctions in the somatic, cognitive and emotional spheres, frequently leading to disability and social dependence. To a greater extent, patients regain their ability, provided they are active in the process of treatment and rehabilitation and have a sense of responsibility for their health. Thus, what becomes particularly important is self-care, understood not only as undertaking basic functions of everyday life, but also as performing actions aimed at improving the patient’s health as well as actions in the scope of secondary prevention. AIM OF THE STUDY. The aim of the study was to learn about the scope and factors determining self-care in people after an ischemic stroke. MATERIALS AND METHODS. 105 patients after their first ischemic stroke participated in the study, checking up after 2 - 3 months after becoming affected. The tests were conducted in the Clinic of Secondary Prevention of Stroke of the University Hospital in Krakow from February 27th 2007, to February 4th 2009, on the basis of the positive opinion of the Bioethics Committee of the Jagiellonian University. Exclusion criteria involved speech and cognitive function disorders preventing active participation in the tests. The diagnostic survey method, the documentation analysis and the following research tools were applied: original questionnaire with a knowledge test on ; the disease, a Mini - Mental State Examination - MMSE, National Institutes of Health Stroke Scale - NIHSS, Repty Functional Index (RFI), Zung Self-Rating Depression Scale - SDS, Generalized Self - Efficacy Scale - GSES, Multidimensional Health Locus of Control Scale form B – MHLC type B, Social Support Scale (SSS) and Patient-Caregiver Functional Unit Scale. Statistical analyses conducted with the use of the IBM SPSS Statistics package, version 26 included descriptive statistics, Student’s t- test for dependent and independent samples, the Mann–Whitney U tests, the ANOVA one-way analysis of variance, the analysis of the correlation of Pearson’s r and Spearman’s rho efficient, and the hierarchical analysis of the linear regression. The level of statistical significance was established as α = 0,05 (p < 0,05). RESULTS. Self-care capacity in the examined was determined at the medium-high level. Those who are city residents, educated, professionally active and of good material status had a higher level of self-care. No significant variations depending on the gender of the examined were observed (p=0,348). The self-care capacity correlated positively with the functional ability (r=0,87), with the knowledge about stroke (r=0,45), as well as the social support (r=0,59). Similarly, a significant correlation between the general sense of self -efficacy (r=0,59) and internal placement of ; health control (r=0,67) was observed. Conversely, a negative correlation was detected between self-care and the symptoms of depression (r=-0,74) and severity of the clinical condition (r=-71). In order to summarize the analyses a hierarchical analysis of the linear regression was performed. In the first model the explanatory factor of variability of self-care was age and it was negatively associated with it. The second model additionally took into consideration somatic and psychosocial factors. In this model the variability of self-care was explained by: functional ability, external type of the health control placement and the sense of self-efficacy (positive associations). In contrast, there was a negative relation of the level of self-care with the presence of the symptoms of depression, with the internal type of the health control placement and with the type enlarging the influence of the case, and also the capacity of the carer. CONCLUSIONS. The ability to self-care in the examined group is at a medium-high level, demanding motivation and informational support. Self-care maintenance is related to all analyzed factors, with the exception of the gender of the examined. The most significant determinants of self-care are functional ability and the presence of the symptoms of depression, as well as personal resources. The scope of assistance from the carer diminishes with the ; increase of self-care entering in the supplementary relation. Due to the application of the criteria for selecting the group the results are not representative of the population of people after an ischemic stroke, however they may be used in education planning and care optimization. The issue of self-care, because of its complexity, demands further research.
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Rada Dyscypliny Nauki o zdrowiu
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Apr 25, 2024
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Mar 9, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5054
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| Edition name | Date |
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