A qualitative exploration of the impact of stroke on the management of pre-existing conditions

Rowland, Victoria

Abstract

Background: Stroke is a leading cause of disability in the UK with 1.3 million people living with the physical and psychosocial impact as part of their daily lives. In addition, over 85% of stroke survivors have at least one pre-existing long-term condition. Previous research on the management of long-term conditions has focussed on a single-disease approach and may not be reliably or helpfully applied to those with multimorbidity. The aim of this study was to explore the impact of having a stroke on the management of pre-existing conditions in the first 3 to 12-months post-stroke.

Method: An exploratory qualitative study was conducted. Fifteen participants (seven males and eight females; mean age 55 years) who had both experienced a stroke in the last 3 to 12-months and had been diagnosed with at least one long-term condition before the stroke, participated in virtual or face-to-face semi-structured interviews. Inductive Reflexive Thematic Analysis was used to analyse the transcribed data.

Findings: Four themes and one subtheme were identified: (1) ‘I was OK I felt fine’ – Positive illness representations prior to stroke. (2) ‘I’ve had one I don’t want any more’ - Stroke as a ‘teachable moment’. (3) Who does what? - Mismatch of expectations. (3.1) ‘It’s self-responsibility for every part of me’ – Self management after stroke. (4) ‘Nothing is going to be the same again’: Acceptance and hope.

Conclusions: Participants held a positive health identity prior to their stroke, despite having pre-existing long-term conditions. The stroke experience challenged participants’ health perceptions, resulting in a teachable moment where self-management and health behaviours changed. Participants were unclear as to who did what in terms of recovery and rehabilitation, including both management of the stroke and existing long-term conditions. Actions to improve health depended on participants’ value of health, what self-management meant to them and the support they received. Although participants had accepted their situation, they hoped their recovery would continue. Recovering from stroke in the context of pre-existing conditions provides additional challenges and considerations throughout the recovery journey. The applicability of the findings and future research are discussed.

• Thesis Type: Thesis
• Deposit Date: Oct 21, 2022
• Publicly Available Date: Jan 9, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10101442
• Award Date: Jan 9, 2023