Cargando…

The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study

BACKGROUND: Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors....

Descripción completa

Detalles Bibliográficos
Autores principales: Ide-Okochi, Ayako, Tadaka, Etsuko, Fujimura, Kazumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3774085/
https://www.ncbi.nlm.nih.gov/pubmed/24134554
http://dx.doi.org/10.1186/1471-2377-13-115
_version_ 1782284458152427520
author Ide-Okochi, Ayako
Tadaka, Etsuko
Fujimura, Kazumi
author_facet Ide-Okochi, Ayako
Tadaka, Etsuko
Fujimura, Kazumi
author_sort Ide-Okochi, Ayako
collection PubMed
description BACKGROUND: Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured person’s attitudes to self-care and long-term health outcomes. METHODS: Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. RESULTS: Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants’ point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers’ active engagement in the participants’ self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. CONCLUSION: Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for persons with CSCI. However, the shift in the meaning of self-care from ADLs to self-management implies more active participation in health care needs, shaped through social exchanges. Not only personal factors but also sociocultural factors influence the injured person’s valuation of self-care. There is a need for further research to better understand sociocultural influences on illness behaviors among persons with CSCI, so that clinical and community practice can develop accordingly.
format Online
Article
Text
id pubmed-3774085
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-37740852013-09-17 The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study Ide-Okochi, Ayako Tadaka, Etsuko Fujimura, Kazumi BMC Neurol Research Article BACKGROUND: Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured person’s attitudes to self-care and long-term health outcomes. METHODS: Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. RESULTS: Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants’ point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers’ active engagement in the participants’ self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. CONCLUSION: Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for persons with CSCI. However, the shift in the meaning of self-care from ADLs to self-management implies more active participation in health care needs, shaped through social exchanges. Not only personal factors but also sociocultural factors influence the injured person’s valuation of self-care. There is a need for further research to better understand sociocultural influences on illness behaviors among persons with CSCI, so that clinical and community practice can develop accordingly. BioMed Central 2013-09-04 /pmc/articles/PMC3774085/ /pubmed/24134554 http://dx.doi.org/10.1186/1471-2377-13-115 Text en Copyright © 2013 Ide-Okochi et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ide-Okochi, Ayako
Tadaka, Etsuko
Fujimura, Kazumi
The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title_full The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title_fullStr The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title_full_unstemmed The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title_short The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study
title_sort meaning of self-care in persons with cervical spinal cord injury in japan: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3774085/
https://www.ncbi.nlm.nih.gov/pubmed/24134554
http://dx.doi.org/10.1186/1471-2377-13-115
work_keys_str_mv AT ideokochiayako themeaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy
AT tadakaetsuko themeaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy
AT fujimurakazumi themeaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy
AT ideokochiayako meaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy
AT tadakaetsuko meaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy
AT fujimurakazumi meaningofselfcareinpersonswithcervicalspinalcordinjuryinjapanaqualitativestudy