A Qualitative Exploration of Stigma following Stroke

Broadhead, Naomi and Murray, Craig and Murray, Craig and Quinn, Karen (2026) A Qualitative Exploration of Stigma following Stroke. PhD thesis, Lancaster University.

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Abstract

This thesis offers a qualitative exploration of the experience of stigma following stroke and comprises three parts: a systematic literature review, an empirical paper, and a critical appraisal of the research process. The systematic literature review synthesised qualitative research exploring stroke survivors’ experiences of stigma and their approaches to coping with such experiences. Using thematic synthesis, four themes were identified: 1) scaffolding stigma: structural and social contexts; 2) age and the paradox of visibility; 3) the weight of burden and internalised shame; and 4) fractured belonging and pathways of resistance. Findings highlighted that stigma emerged within an ecological framework, with micro-, meso-, and macro-level influences. Clinical implications are discussed, particularly regarding the role of clinical psychology in stroke care. The empirical paper explored the post-stroke experiences among eight participants with a particular focus on the role of stigma in shaping recovery trajectories. Phenomenologically informed thematic analysis was used to analyse the interview transcripts, and three themes were developed: 1) youth and legitimacy; 2) “still me?”: reconstructing identities in the shadow of youth; and 3) lost in the gaps: systemic blind spots in care. The findings highlighted how participants negotiated disbelief and exclusion linked to age, reconstructed disrupted identities amidst disclosure dilemmas, and navigated fragmented care systems designed primarily for older populations. Implications for clinical practice and future research are discussed. Finally, the critical appraisal summarises the research, examining convergence and divergence between the literature review and empirical findings. It also offers some reflections and insights into the process of undertaking qualitative research on stigma and stroke recovery.