BACKGROUND Botulinum toxin (BT) injection is a new treatment for spasticity with hemiplegia after stroke. How a patient decides to receive BT injections after becoming aware of the treatment remains unclear. In this exploratory qualitative study, we aimed to investigate patients' decision-making about treatment strategies in collaboration with family and health professionals and to identify conflicts in patients' feelings about BT treatment. METHODS The study included six patients with stroke sequelae. Data were collected using comprehensive interviews and were analyzed using the grounded theory approach and trajectory equifinality modeling. RESULTS After patients learned about BT treatment, they clearly exhibited the following two concurrent perceptions: "the restriction of one's life due to disabilities" and "the ability to do certain things despite one's disabilities." Some patients reported a "fear of not being able to maintain the status quo owing to the side effects of BT." To alleviate this fear, timely support from family members was offered, and patients overcame anxiety through creative thinking. However, there were also expressions that revealed patients' difficulties dealing with negative events. These factors influenced the patients' development of "expectations of BT" or "hesitations about BT." CONCLUSIONS To establish treatment strategies in collaboration with patients, healthcare professionals should show supportive attitudes and have discussions with patients and their family members to help patients resolve their conflicts and should establish treatment strategies that maintain the positive aspects of patients' lives.

中文翻译：

---

慢性半身不遂中风患者肉毒杆菌毒素注射的选择过程：一项定性研究。

背景技术肉毒杆菌毒素（BT）注射液是中风后偏瘫痉挛的一种新疗法。尚不清楚患者在意识到治疗后如何决定接受BT注射。在这项探索性定性研究中，我们旨在与家庭和卫生专业人员合作调查患者对治疗策略的决策，并确定患者对BT治疗的感觉上的矛盾。方法该研究包括6例中风后遗症患者。使用综合访谈收集数据，并使用扎实的理论方法和轨迹等价性模型进行分析。结果在患者了解BT治疗后，他们清楚地表现出以下两种同时出现的感觉：“由于残疾而限制生命”和“