뇌졸중 환자의 적응 과정에 대한 근거이론적 접근

Abstract

Stroke patients experience not only physical problems but also various psychological and social problems, and their adjustment to the life with disability is a big challenge. Although there have been many studies dealing with stroke, most of them are focused on quantitative data rather than qualitative. The purpose of this study was to describe the adaptation process of stroke patients. The question for the study is "How stroke patients ate becoming to adapt to their lifes?". The research method used in this study was the Grounded Theory Method developed by Strauss & Corbin (1998). Eighteen participants for this study, who had a stroke, were hospitalized or visited the OPD regularly in Jeju National University Hospital. Their age ranged from 48 to 68 years old. The duration after stroke ranged from 1 to 32 months. The data collection period was from April, 2013 to October, 2013. The data were collected through in-depth interview with the participants, and theoretical sampling were attempted until the data reached saturation. Data collection and data analysis were performed simultaneously. For the result of the study, 46 concepts, 18 subcategories were derived from the open coding. From the category analysis based on the axial coding, the central phenomenon emerged as 'hopelessness', 'self-pity and chagrin ', 'anger', 'powerlessness'. The causal conditions that influence this phenomenon are 'loss of function' and 'unacceptable attack'. The contextual conditions are 'disability in everyday life' and 'recognition burden and dependence'. The action/interaction strategies were 'concentrate on self', 'hide myself', 'reinterpretation of the situation','compromise myself', 'daily life adjustment'. Intervention conditions are 'familial coping' and 'others coping'. 'Altered self-esteem', 'endure limits', 'maintaining daily life' also emerged from the data as consequence. In selective coding, a core category was expressed as 'adjust and accept the diminished life'. A continuous analysis of the results reveal there were 3 types -'fidelity', 'hesitation' and 'negligence'- derived with the analysis of the adaptation process in stroke patient. The 'fidelity' type satisfies themselves and is content with their current life. The 'hesitation' type passively accepts the reality. The 'negligence' type has regrets about his past life and nothing left to live. The result of this study provides a essential knowledge and insight for individualized nursing intervention strategies in helping the adaptation of stroke patients.