Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
The action-theoretical model of Selective Optimisation with
Compensation (SOC) (Baltes & Baltes, 1990) and perceived control
(Partridge & Johnston, 1989) were proposed in this study to explore
the contribution of psychological processes in determining recovery
after stroke. The SOC model provides a general theory for
conceptualising processes of successful development in general and
was originally designed and developed as an explanatory framework
for adaptation to ageing (Li & Freund, 2005). It has been applied
mainly to the process of successful ageing and successful life
management (Baltes & Lang, 1997; Freund & Baltes, 1998). Greater
use of SOC adaptive strategies have been associated with higher
levels of psychological well being (Freund & Baltes, 2002) and
better physical health (Freund & Baltes, 1998) in general ageing
populations. Perceived control has been conceptualised as the
extent to which individuals’ believe that they control key processes
over their internal state and behaviour and has been supported as a
valid construct of control over recovery from chronic conditions or
illness (Turk, Rudy, & Salovey, 1986). Empirical research has
confirmed the predictive value of perceived control in determining
functional recovery three years after stroke (Johnston, Pollard,
Morrison, & MacWalter, 2004). The aim of this longitudinal study is
to examine the influence personal factors such as adaptive
strategies, perceived control and socio-demographics have on
activity limitations and participation restrictions one year after
stroke. The specific objectives are to examine the association
between personal factors and activity and participation; and to
examine if personal factors predict improved activity and
participation one year after stroke.
Method
Patient selection and sociodemographics
Patients were recruited from three large urban teaching hospitals
and one small district general hospital in the Republic and Northern
Ireland. All consecutive admissions with a confirmed diagnosis of
stroke (defined as symptoms of rapid onset lasting more than 24
hours and of presumed vascular origin reflecting a focal disturbance
of cerebral function, excluding isolated impairment of higher
function) were considered eligible for the study. Patients admitted
with transient cerebral ischaemic attacks and related syndromes,
traumatic intracranial and subarachnoid haemorrhage and prestroke
vascular dementia were deemed unsuitable and excluded
from the study. Patient socio-demographic and clinical background
information included age, gender, marital status, living
arrangements, socio-economic status (manual and other social
classes including self-employed and non-manual), past medical
history, other co-morbidities during this admission, stroke subtype,
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