A tension between surrendering and being involved: An interview study on person-centeredness in clinical reasoning in the acute stroke setting

PATIENT EDUCATION AND COUNSELING(2023)

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摘要
Objective: To explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the acute phase of stroke care.Methods: An explorative qualitative design was used. Individual interviews were conducted with 11 stroke survivors in the acute phase of care and analyzed using reflexive thematic analysis. Results: The analysis identified five themes: What's going on with me?; Being a recipient of care and treatment; The need to be supported to participate; To be seen and strengthened; and Collaboration and joint understanding.Conclusion: Stroke survivors experience many attributes of person-centeredness in the acute phase of care but, according to their stories, their participation in clinical reasoning can be further supported. The tension between surrendering and the desire to be more actively involved in the care needs to be considered to facilitate participation in clinical reasoning.Practice Implications: Stroke survivors' participation in clinical reasoning in the acute phase can be facilitated by health professionals noticing signs prompting a shift towards increased willingness to participate. Furthermore, health professionals need to take an active role, sharing their expertise and inviting the stroke survivors to share their perspective. The findings can contribute to further develop person-centered care in acute settings.
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关键词
clinical reasoning,acute stroke,person-centeredness
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