Loss, Gain, and the Reframing of Perspectives in Long-Term Stroke Survivors: A Dynamic Experience of Quality of Life

Abstract

Themes described quality of life as a dynamic experience that changed as activities of value were lost or gained and as participants experienced changes in their perspectives, beliefs, values, and behaviors. The discussion examines these themes through the lens of the Model of Human Occupation and the Shifting Perspectives Model of Chronic Illness. Clinical implications of the results are also discussed.

Development and Evaluation of a Hospital-Based Peer Support Group for Younger Individuals with Stroke

“…Using the Model of Human Occupation (MOHO), authors found that transformational or catastrophic change to occupations and roles through stroke directly influenced self-efficacy, life satisfaction, and daily activities. Bourland et al, (2011) also found that individuals who engage in meaningful occupations after discharge from hospital settings reported higher QoL and positive perspectives on healing. The authors found that individuals with chronic illness demonstrate the ability to adapt by replacing old occupations with new ones, an opportunity that is achievable through group processes.…”

“…In terms of quality of life (QoL), Bourland et al (2011) examined long-term coping focused on understanding the lived experience of QoL in six individuals between the ages of 60-70 with long-term stroke. Using the Model of Human Occupation (MOHO), authors found that transformational or catastrophic change to occupations and roles through stroke directly influenced self-efficacy, life satisfaction, and daily activities.…”

“…As a profession sensitive to the holistic needs of clients with stroke, occupational therapists working with neurological populations must address the psychosocial factors that can affect engagement in occupation after injury. These may include decreased satisfaction with life roles, changes in self worth and self-image, coping issues, and changes in social roles (Bourland et al, 2011;Ch'Ng et al, 2008;Cole, 2005;Cole & Tufano, 2008). The foundational philosophies of occupational therapy provide a rich framework for designing group interventions grounded in meaningful activity to address such risk factors (Cole, 2005).…”

The experiences of everyday activities post-stroke

“…Understanding stroke survivors' lived experiences can provide valuable insights to practitioners, family members and others invested in promoting the recovery process for stroke survivors [2,[16][17][18][19]. Determining effective interventions requires combining scientific knowledge with knowledge of the client's lived experience [14], which is especially important when addressing stroke survivors' diminished quality of life experienced upon return to the community.…”

“…As participants are able to engage in meaningful activities, they can experience a sense of successful adjustment [28], as well as a sense of fulfillment and enjoyment [22]. When stroke survivors were asked about experiences that positively influenced their quality of life, engagement in meaningful activities was consistently revealed to be essential [16]. Changes in ability to do and in perspectives led to changes in quality of life.…”