Vécu des pertes d’autonomie des personnes victimes d’AVC et instabilité psycho-sociale de la famille : Une étude de cas.

Abstract

Stroke is an imprecise generic term, corresponding to very different pathophysiologies, clinically presenting as a focal or global neurological deficit lasting more than 24 hours. It treatments, prognosis and secondary prevention can be radically different. This definition implies the existence of a cerebral lesion following an underlying vascular lesion. Indeed, it can be thought that stroke survivors over-interpret the intensity of the stress they were exposed to posteriori to the event. They seek explanations for what happened to t hem and they become more sensitive than before. The scientific problem targeted in our work was on the management of the consequences of neurological sequelae to the stroke patient and to his family through a battery of psychosocial care. Thus, our aim to bring up a modest contribution for a better psychosocial care to subjects with stroke and their environment. To resolve this problem, we sought to answer the question on: “does the experience of loss of autonomy by stroke victims determine the psychosocial instability of the family». To achieve this, we formulated our research topic as follows: "experience of loss of autonomy by stroke victims and their family psychosocial instability". As explanatory theory, we have convened 3 theories: the Freudian theory of social suffering the resilience theory by Boriscyrulnik theory of pain and Melzack model for pain management. We adopted a qualitative approach. To find an answer to this question, we have made the general assumption that: the loss of autonomy experienced by stroke victims determines the psychosocial instability in their family. From this general hypothesis were derived four other research hypotheses namely: HR1: "the experience of urinary and faecal incontinence by stroke victims determines the psychosocial instability by family members» HR2: "the experience of left or right hemiplegia with or without partial contralateral involvement in stroke patients determines the psychosocial instability of the family" HR3: "the experience of speech loss in stroke patients determines the psychosocial instability of the family" HR4: "The experience of vision loss in stroke patients determines the psychosocial instability of the family" We conducted semi-structured interviews for data collection using a predefined conversation frame and an analysis guide. Was enrolled a total population of 15 subjects, and on the basis of a reasoned technique we included as study population 09 cases. Our analysis was a grouped analysis. Based on the data analysis and interpretations, our general hypothesis was validated. Hence, the experience of loss of autonomy following stroke leads to psychosocial instability by victims and their family members.