Quality of life in a young female patient after ischemic stroke: an interpretative phenomenological analysis
Authors:
Š. Šaňáková 1; E. Gurková 1; L. Machálková 1; L. Mazalová 1; D. Bartoníčková 1; D. Šaňák 2
Authors‘ workplace:
Univerzita Palackého v Olomouci Fakulta zdravotnických věd, Ústav ošetřovatelství Přednostka: Mgr. Daniela Bartoníčková
1; Fakultní nemocnice Olomouc, Neurologická klinika Přednosta: prof. MUDr. Petr Kaňovský, Ph. D.
2
Published in:
Prakt. Lék. 2023; 103(4): 202-207
Category:
Case Report
Overview
Objective: To find out the life experiences of a patient after an ischemic stroke (IS) at a young age and what effect this disease had on the quality of her further life (Health Related Quality of Life, HRQoL).
Methodology: The pilot study had the characteristics of an interpretative phenomenological case study. Data collection was carried out through an in-depth semi-structured interview focusing on the areas of the investigated phenomenon. The interview transcript was analysed based on interpretative phenomenological analysis (IPA).
Participant: 45-year-old woman, two years after IS, self-employed bar operator before the illness. As a result of the lingering consequences after IS (fatigue, expressive phatic disorder, slight right arm paresis and depression), she is on disability pension.
Results: A total of 8 themes were identified that describe the patient's experience with the consequences of IS. We characterized these themes as: It was beyond me – timely and adequate provision of health care; I was nobody – the consequences of severe aphasia; I was lively, cheerful, wild – loss of integrity; Fatigue – change in daily rhythm; I was everywhere, now always at home – social isolation; I have already learned to walk and talk – the benefit of intensive RHB and speech therapy care; Successes in small steps – a gradual return to normal life; Partner and family as help, support and motivation – a new dimension of relationships.
Conclusion: Despite the significant improvement of the clinical condition after IS, its impact on the quality of life can be very significant. In the case of the referred young patient, her recovery took many months to years despite intensive rehabilitation, speech therapy and psychological support. Fatigue, depressive mood, abulia, social isolation persist for a long time. Adequate care for these patients requires a highly individualized approach by multidisciplinary teams.
Keywords:
stroke – Quality of life – interpretative phenomenological analysis – case study
Sources
- Balasooriya-Smeekens C, Bateman A, Mant, J, et al. Barriers and facilitators to staying in work after stroke: insight from an online forum. BMJ Open. 2016; 6(4): e009974.
- Becker K, Kohen R, Lee R, et al. Poststroke fatigue: hints to a biological mechanism. J Stroke Cerebrovasc Dis. 2015; 24(3): 618–621.
- Cséfalvay Z, Traubner P. Afaziológia pre klinickú prax. Martin: Osveta 1996.
- El Masry Y, Mullan B, Hackett M. Psychosocial experiences and needs of Australian caregivers of people with stroke: prognosis messages, caregiver resilience, and relationships. Top Stroke Rehabil. 2015; 20(4): 356–368.
- Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol. 2018; 17(9): 790–801.
- Efstratiadou EA, Chelas EN, Ignatiou M, et al. Quality of life after stroke: evaluation of the Greek SAQOL-39g. Folia Phoniatr Logop. 2012; 64(4): 179–186.
- Gurková E, Štureková L, Mandysová P, et al. Factors affecting the quality of life after ischemic stroke in young adults: a scoping review. Health Qual Life Outcomes. 2023; 21(4): 1–15.
- Gurková E, Štureková L, Šaňáková Š, et al. Young adults’ experience of ischemic stroke – a qualitative research synthesis. Kontakt. 2023 [online]. Dostupné z: https://kont.zsf.jcu.cz/ getrevsrc.php?identification=public&mag=knt&raid=1132&type=fin&ver=1 [cit. 2023-09-08].
- Harris Walker G, Oyesanya TO, Hurley A, et al. Recovery experiences of younger stroke survivors who are parents: A qualitative content analysis. J Clin Nurs. 2021; 30(1–2): 126–135.
- Hilari K, Byng S. Health-related quality of life in people with severe aphasia. Int J Lang Commun Disord. 2009; 44(2): 193–205.
- Hilari K, Northcott S, Roy P, et al. Psychological distress after stroke and aphasia: the first six months. Clin Rehabil. 2010; 24(2): 181–190.
- Hilari K, Needle J, Harrison K. What are the important factors in health-related quality of life for people with aphasia? A systematic review. Arch Phys Med Rehabil. 2012; 93(Suppl 1): S83–S95.
- Hoang CL, Salle JY, Mandigout S, et al. Physical factors associated with fatigue after stroke: an exploratory study. Top Stroke Rehabil. 2012; 19(5): 369–376.
- Holloway A, Chandler C, Aviles Reinso L, et al. Young Adults Rehabilitation Needs and Experiences following Stroke (YARNS): A review of digital accounts to inform the development of age-appropriate support and rehabilitation. J Adv Nurs. 2022; 78(3): 869–882.
- Hutton L, Ownsworth T. A qualitative investigation of sense of self and continuity in younger adults with stroke. Neuropsychol Rehabil. 2019; 29(2): 273–288.
- Immenschuh U. Being left alone younger people who have suffered a stroke. PR-Internet fur die Pflege. 2004; 6(7–8): 426–431.
- Institut biostatistiky a analýz. IKTA.CZ: Celonárodní registr pacientů s cévní mozkovou příhodou: neintervenční, multicentrická, prospektivní studie [online]. Dostupný z: https://www.registry.cz/ index.php?pg=registry&prid=44 [cit. 2023-09-08].
- Kuluski K, Dow C, Locock L, et al. Life interrupted and life regained? Coping with stroke at a young age. Int J Qual Stud Health Well-being. 2014; 9: 22252.
- Leahy DM, Desmond D, Coughlan T, et al. Stroke in young women: An interpretative phenomenological analysis. J Health Psychol. 2016; 21(5): 669–678.
- Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, et al. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol. 2014; 10(6): 315–325.
- Maaijwee NA, Arntz RM, Rutten-Jacobs LC, et al. Post-stroke fatigue and its association with poor functional outcome after stroke in young adults. J Neurol Neurosurg Psychiatry. 2015; 86(10): 1120–1126.
- Morris R. The psychology of stroke in young adults: the roles of service provision and return to work. Stroke Res Treat. 2011; 2011: 534812.
- Novák T. Depresivní porucha po cévní mozkové příhodě. Neurol. Praxi. 2019; 20(5): 377–382.
- Řepík T, Štibraná K, Čeledová L, a kol. Problematika posuzování invalidity po prodělané cévní mozkové příhodě. Cesk Slov Neurol N. 2023; 86(2): 148–152.
- Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: theory, method and research. Thousand Oaks: Sage Publications 2009.
- Smith JA, Nizza IE. Essentials of interpretative phenomenological analysis. Washington, D.C.: American Psychological Association 2022.
- Ústav zdravotnických informací a statistiky ČR. Hospitalizovaní a zemřelí na cévní nemoci mozku v ČR v letech 2003–2010 [online]. Dostupné z: https://www.uzis.cz/sites/default/files/ knihovna/03_12.pdf [cit. 2023-09-08].
- Vitturi BK, Mitre LP, Kim AIH, et al. Prevalence and predictors of fatigue and neuropsychiatric symptoms in patients with minor ischemic stroke. J Stroke Cerebrovasc Dis. 2021; 30(9): 105964.
- Wolfenden B, Grace M. Vulnerability and post-stroke experiences of working-age survivors during recovery. Sage Open. 2015; 5(4) [online]. Dostupné z: https://journals.sagepub.com/doi/ epub/10.1177/2158244015612877 [cit. 2023-09-08]
- Yahya T, Jilani MH, Khan SU, et al. Stroke in young adults: current trends, opportunities for prevention and pathways forward. Am J Prevent Cardiol. 2020; 3: 100085.
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2023 Issue 4
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