Illness beliefs and emotional responses in mildly disabled stroke survivors: A qualitative study

PLoS One. 2019 Oct 23;14(10):e0223681. doi: 10.1371/journal.pone.0223681. eCollection 2019.

Abstract

Background: As acute stroke services improve, more persons experience mild stroke and need to cope daily with hidden disabilities, which may be influenced by how they perceive stroke, cognitively and emotionally.

Objective: To investigate cognitive illness beliefs and emotional responses in persons with mild stroke and their possible influences on daily coping.

Methods: Semi-structured interviews were conducted with 24 persons with mild stroke, on average 7.5 months (±0.89) after stroke occurrence. A thematic analysis on verbatim transcripts was guided by the Common-Sense Model of Self-Regulation.

Results: All participants experienced difficulties constructing an illness identity at both acute and chronic phase. Behavioral risk factors were less accepted as causes of stroke. Lack (or inappropriate timing) of information from healthcare providers led to limited medication knowledge and low perceived control of stroke recurrence which generated anxiety, fear, and low involvement in coping. Participants who considered stroke a chronic condition experienced more difficulties. Perceived support from relatives and healthcare providers was beneficial for participation in recovery and health behaviour change.

Conclusion: Despite having mildly disabilities, participants reported difficulties developing illness beliefs conducive to coping, and dealing with their emotional responses. These elements should be considered in tailored programs to improve coping with hidden disabilities post-stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Aged, 80 and over
  • Culture*
  • Disabled Persons / psychology*
  • Emotions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Stress, Psychological
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / psychology*
  • Surveys and Questionnaires
  • Survivors / psychology*

Grants and funding

CDV was supported by a PhD grant from the Auvergne Rhône-Alpes region. This work was supported by the RHU MARVELOUS (ANR-16-RHUS-0009) of l’Université Claude Bernard Lyon 1 (UCBL), within the program "Investissements d'Avenir“ operated by the French National Research Agency (ANR), the “Prevent’horizon” French Excellence Research Chair and the French institute of public health research (IRESP) (AAP Handicap 2015). This work was also supported by the ALLP. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.