‘Emotion is of the essence. … Number one priority’: A nested qualitative study exploring psychosocial adjustment to stroke and aphasia

Background: Stroke and aphasia can have a profound impact on people’s lives, and depression is a common, frequently persistent consequence. Social networks also suffer, with poor social support associated with worse recovery. It is essential to support psychosocial wellbeing post-stroke, and examine which factors facilitate successful adjustment to living with aphasia.
Aims: In the context of a feasibility randomised controlled trial of peer-befriending (SUPERB), this qualitative study explored adjustment for people with aphasia in the post-acute phase of recovery, a phase often neglected in previous research.
Method and procedures: Semi-structured interviews were conducted with 20 people with aphasia and ten significant others, who were purposively sampled from the wider group of 56 people with aphasia and 48 significant others. Interviews took place in participants homes; they were analysed using Framework Analysis.
Outcomes and results: Participants with aphasia were 10 women and 10 men; their median (IQR) age was 70 (57.5-77). Twelve participants had mild aphasia, eight moderate-severe. Significant others were six women and four men with a median (IQR) age of 70.5 (43-79). They identified a range of factors that influenced adjustment to aphasia post-stroke. Some were personal resources, including: mood and emotions; identity/sense of self; attitude and outlook; faith and spirituality; moving forward. Significant others also talked about the impact of becoming carers. Other factors were external sources of support, including: familial and other relationships; doctors, nurses and hospital communication; life on the ward; therapies and therapists; psychological support, stroke groups and community and socialising.
Conclusions and implications: To promote adjustment in the acute phase, hospital staff should prioritise the humanising aspects of care provision. In the post-acute phase, clinicians play an integral role in supporting adjustment and can help by focusing on relationship-centred care, monitoring mental health, promoting quality improvement across the continuum of care and supporting advocacy.

This is the peer reviewed version of the following article: Moss, B. et al (2021) Emotion is of the essence …. Number one priority’: a nested qualitative study exploring psychosocial adjustment to stroke and aphasia, International Journal of Language and Communication Disorders, which will be published in final form at: https://onlinelibrary.wiley.com/journal/14606984

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