Rebuilding and restructuring the world following rapid comprehensive assessment and treatment for an acute stroke

Abstract

Management of acute stroke has changed through implementation of rapid comprehensive assessment and treatment. Stroke as a medical emergency and expectancy of recovery has implications on how patients cognitively process the impact of their stroke. Current literature focuses on long term recovery and little is known about patients' experiences and cognitive processing during the acute phase. Semi-structured interviews were completed with 6 patients on a stroke unit, London, UK, between October and December 2012. The interview schedule was based on interviews with a clinical nurse specialist, stroke patient and previous literature. Interviews took place during hospital admission following transfer from a hyper acute stroke unit. Data were analysed using Interpretative Phenomenological Analysis. Participants ages ranged from 68 to 94 years, the emergent super-ordinate themes from this sample receiving a diagnosis of an acute stroke included: (1) disassociation from bodies, self and abilities; (2) search for understanding; (3) striving for independence and acceptance of support; and (4) hope and uncertainty. Although there were variations in participants' experiences these themes capture the experience of the participants collectively. All participants applied cognitive processes to commence the rebuilding and restructuring of their world. Participants began this process in the acute stage of their stroke.