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.

Graphical Abstract

KEYWORDS:

• Quality of life
• stroke
• recovery
• self
• embodiment
• fatigue
• qualitative research

Acknowledgments

The authors acknowledge the participants for generously sharing their experiences and time and the health-care professionals for contributing to the recruitment process.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors disclose the following financial support for the research, authorship, and publication of this article: The Northern Norway Regional Health Authorities funded this work (grant no. SFP1174-14); Helse Nord RHF.

Notes on contributors

Synne G. Pedersen

Synne G. Pedersen, PT, MSc (neurological physiotherapy), PhD-student, Specialist in clinical neurological physiotherapy, Department of Rehabilitation, University Hospital of North Norway. Research interests: Stroke rehabilitation, function, movement quality, recovery, clinical reasoning in physiotherapy.

Audny Anke

Audny Anke, MD, Specialist in Physical Medicine and Rehabilitation, PhD, Department of Rehabilitation, University Hospital of North Norway. Professor at Department of Clinical Medicine, Faculty of Health Sciences, UIT—The Artic University of Norway. Research interests: Outcome and rehabilitation pathways after severe multiple trauma and traumatic brain injury, as well as stroke. Persistent pain. Family member circumstances. Health, functioning and activity in individuals with intellectual disabilities.

Lena Aadal

Lena Aadal, RN, Cand. Cur, PhD, Associate professor, Department of Clinical Medicine, Aarhus University, Head of Clinical Nursing Research at Hammel Neurorehabilitation and Research Clinic. Research interests: Clinical interdisciplinary research with an emphasis on nursing interventions during rehabilitation after acquired brain injuries. Interdisciplinary and cross-sectoral rehabilitation after brain injury.

Hanne Pallesen

Hanne Pallesen, PT, MSc (health), PhD, Associate professor, Department of Clinical Medicine, Aarhus University. Head of Clinical Physiotherapy Research at Hammel Neurorehabilitation and Research Clinic. Research interests: Remaking the body, disability, self-efficacy, self-management and self-identity, patient perspectives, interdisciplinary and cross-sectoral recovery after brain injury.

Siri Moe

Siri Moe, PT, PhD, Associate Professor, Department of Health and Care Sciences, Faculty of Health Sciences, UIT—The Arctic University of Norway. Research interests: Community health care practice, interprofessional collaboration, rehabilitation, physiotherapy practice, movement as a social phenomenon.

Cathrine Arntzen

Cathrine Arntzen, PhD, Leader of Centre for Care Research, north, Associate professor, Department of Health and Care Sciences, UIT—The Arctic University of Norway. Senior researcher at the Division of Rehabilitation Services, University Hospital of North Norway. Research Interests: Stroke rehabilitation, dementia care, occupational therapy and health care services in the municipality.