The process by which patients become aware of unilateral spatial neglect: A qualitative study

ABSTRACT

Unilateral spatial neglect (USN), which can occur post-stroke, significantly impacts patients’ daily lives. We explored the process by which patients become aware of the facets of their USN from the acute to subacute phase using a qualitative method. Participant observations, semi-structured interviews, and medical-record surveys were conducted with eight patients with USN and thirty healthcare professionals. We identified three themes regarding the patients’ USN awareness process: inconsistency between present symptoms and perception of the left side, reconsidering the reasons for a vagueness on the left side, and acceptance of neglecting the left side. Additionally, healthcare professionals’ support consisted of four strategies: assessing patients’ perception of stimuli on their left side, compensating for patients’ behaviours, promoting awareness of USN, and promoting activities that involve the use of residual functions after a cerebrovascular accident. Patients with USN gradually became aware of their deficits through interactions with others, and they responded by creating and practicing their own self-developed management strategies. These findings indicate that recovery from USN requires a series of experiences and social interactions. A comprehensive understanding of the process of awareness and adaption to USN from onset to recovery can help provide support for patients with USN.

KEYWORDS:

• Ethnographic approach
• Nursing
• Healthcare professionals
• Patient experience
• Unilateral spatial neglect

Acknowledgements

We would like to thank the two collaborating hospitals that made recruitment of participants possible, and give our heartfelt gratitude to the patients, nurses, and therapists who participated in this research. We gratefully acknowledge the work of past and present members of the laboratory in the department of critical and invasive-palliative care nursing. We are also particularly grateful to Junior Associate Professor Mayumi Uchibori for her advice concerning qualitative analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.