A qualitative exploration of stroke, identity and person-centred rehabilitation

Richardson, Hannah and Murray, Craig and Read, Jessica (2024) A qualitative exploration of stroke, identity and person-centred rehabilitation. PhD thesis, Lancaster University.

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Abstract

Section one details a systematic literature review, exploring the impact of stroke on the identity of young stroke survivors. A systematic search of three databases returned 14 papers, which were synthesised using thematic synthesis. Findings highlight the impact of stroke on the identity of young survivors, specifically in relation to the loss of their pre-stroke identity, including self-defining roles, and the need for development of a new sense of self, such as their identity as a young stroke survivor. The need for psychological support and person-centred rehabilitation specific to this cohort of stroke survivors, and additional clinical implications are discussed. Section two presents a qualitative exploration of clinicians’ experiences of delivering person-centred stroke rehabilitation and the facilitators and barriers to delivering such rehabilitation. Data was collected from 15 participants through online focus groups, and analysed using thematic analysis. From this, four themes emerged: (1) clinicians’ experiences of delivering person-centred stroke rehabilitation, examining the person-centred ethos within practice and services (2) psychological factors, relating to psychological barriers in the delivery of person-centred rehabilitation (3) the importance of multi-disciplinary team working (4) systemic factors influencing person-centred rehabilitation. Clinicians were found to value person-centred rehabilitation, as well as inter-disciplinary team working. Psychological barriers to rehabilitation for both patients and clinicians were identified, and clinical implications are discussed in relation to the role of clinical psychology in stroke rehabilitation. Section three presents a critical appraisal, highlighting the practical, methodological and ethical challenges encountered in the development of the empirical paper and explores reflections from this process. Additionally, the synergies between sections one and two are discussed, and recommendations offered regarding the role of clinical psychology in stroke rehabilitation and potential future research.