title: Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK.
abstract: Stroke is a sudden-onset condition with long-term consequences. Self-management could help address long-term consequences of stroke. Stroke survivors' and health professionals' views of self-management may vary, limiting the successful introduction of self-management strategies. This paper explores stroke survivors' and physiotherapists' views of self-management, focusing on what self-management means, and factors perceived to enable and hinder self-management after stroke, to draw out implications for policy, practice and future research.
  
  
  
  Qualitative study using semistructured interviews and a thematic analysis approach.
  
  
  
  Stroke unit and community stroke-rehabilitation services in London, UK.
  
  
  
  13 stroke survivors (8 men and 5 women; aged 53-89 years) admitted to a London stroke unit. 13 physiotherapists: 8 working in an inpatient stroke unit and 5 in community rehabilitation.
  
  
  
  Key differences were evident in how self-management was understood between these groups. Stroke survivors were unfamiliar with the term self-management, but most could provide their own definition and relate to the term, and understood it as care of the self: 'doing things for yourself' and 'looking after yourself'. They did not recognise self-management as part of their care, but valued therapists as encouraging experts in supporting their recovery after stroke. Physiotherapists commonly understood self-management as a process in which stroke survivors were expected to take an active role in their rehabilitation and manage their recovery and health, with different understandings of self-management among physiotherapists shaped by the context in which they worked. They reported that individual, social and organisational factors enable and hinder self-management after stroke, with individual and organisational barriers particularly evident in the early stages.
  
  
  
  If self-management support approaches are to be used, further work is required to explore the language and strategies used by professionals to support self-management, and the barriers to supporting self-management at different time points after stroke.
authors.affiliation: Health Service and Population Research Department, King's Improvement Science, Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Euan
authors.initials: E
authors.lastname: Sadler
authors.affiliation: Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, UK.|National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London, London, UK.|National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, Tower Wing Guy's Hospital, London, UK.
authors.forename: Charles D A
authors.identifier: 0000-0001-8264-0981
authors.initials: CD
authors.lastname: Wolfe
authors.affiliation: Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Jones
authors.affiliation: Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, UK.|National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London, London, UK.|National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, Tower Wing Guy's Hospital, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D059825:Physical Therapists; D036301:Qualitative Research; D012648:Self Care; D000073278:Self-Management; D020521:Stroke; D000071939:Stroke Rehabilitation; D017741:Survivors
keywords: QUALITATIVE RESEARCH; self-management