Experiences of quality of life the first year after stroke in Denmark and Norway. A qualitative analysis

Abstract

Purpose: This study aims to explore quality of life (QOL) during the first year of recovery after stroke in North Norway and Central Denmark. Method: Individual in-depth interviews with 11 stroke survivors were performed twelve months after stroke onset. An interpretative, inductive approach shaped the interview process and the processing of data. Results: We found that QOL reflected the individuals’ reconstruction of the embodied self, which was identified by three intertwined and negotiating processes: a familiar self, an unfamiliar self, and a recovery of self. Further, we found that reconstruction of the embodied self and QOL could be framed as an ongoing and interrelated process of “being, doing, belonging and becoming”. Enriching social relations, successful return to work, and continuity and presence in professional support during recovery enhanced the experience of QOL. Fatigue and sustained reduced function hindered participation in meaningful activities and influenced the perceived QOL negatively. Conclusions: The two countries differed in descriptions of continuity and support in the professional follow-up during the recovery process, influencing the degree of encouragement in reconstructing the embodied self. Reconstruction of the embodied self is a means of understanding stroke survivors’ QOL during the first year of recovery, supporting an individualized and tailored rehabilitation practice.

Stroke-Specific Quality of Life one-year post-stroke in two Scandinavian country-regions with different organisation of rehabilitation services: a prospective study

“…In our study, both cohorts scored lowest in the energy domain one-year post-stroke. Fatigue is common after stroke, tends to persist, and contributes to lower QOL [49,50]. The SS-QOL is the only stroke-specific multidimensional instrument that includes this element to measure stroke-specific HRQOL, which may give the measure an advantage.…”

Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis

“…Fatigue has been described as a state of weariness unrelated to previous exertion levels, which is usually not ameliorated by rest, and as a chronic and subjective feeling of lack of energy, weariness and aversion to effort [3]. PSF is associated with higher risk of institutionalization and death and impedes patients' rehabilitation [4] and quality of life [5]. Although fatigue in the acute phase is often considered a normal and temporary feature following stroke, Lerdal et al [6] identified fatigue in the acute phase as an independent predictor of poorer physical health 36 months after stroke.…”

“I can manage the challenge” – a qualitative study describing experiences of living with balance limitations after first-ever stroke

“…This is similar to the findings by Pallesen et al (2019) who report that stroke survivors find that they have to deal with the impairments after the stroke, but they also learn to manage and overcome challenges by being active and participating in everyday life (Pallesen et al, 2019 ). Active coping strategies have a positive impact on quality of life after stroke (Lo Buono et al, 2017 ; Ostir et al, 2008 ) and subjectively experienced wellbeing is related to the ability to manage the consequences of a stroke (Lo Buono et al, 2017 ; Pedersen et al, 2019 ).…”