EVALUATING A PILOT COMMUNITY STROKE SERVICE USING INSIGHTS FROM MEDICAL ANTHROPOLOGY

This paper focuses on the evaluation of a pilot community stroke servi ce. Its aim is to illustrate how the insights gained from the research of two medical anthropologists, Kaufman and Finder, provided an under standing of the experience of chronic illness in the community. Two li nked themes identified in the literature, which also emerged from the exploratory phase of the evaluation, are discussed: the tension betwee n the patient's goal of recovery and the professional's goal of rehabi litation; and the management of uncertainty. It is argued that it may be very difficult, if not impossible, to reconcile these divergent goa ls of recovery and rehabilitation, and that this problem is exacerbate d for patients and professionals alike by the challenge of how to mana ge the uncertainty of a chronic illness such as stroke. The empirical findings of the first phase evaluation corroborate Kaufman and Finder' s findings. Furthermore, the present research suggests that the mismat ch between the goals of recovery and rehabilitation, and the managemen t of uncertainty are integrally related. The implications for practice are that there is a need for professionals to find ways of recognizin g and taking account of the possible tensions between their goals and those of patients and families, and related to this, for the developme nt of strategies which enable professionals to explain clearly the nat ure of stroke to patients aid their carers.