Perceptions of self-rated health among stroke survivors: a qualitative study in the United Kingdom

N Mavaddat, E Sadler, L Lim, K Williams, E Warburton, A L Kinmonth, J Mant, J Burt, C McKevitt, N Mavaddat, E Sadler, L Lim, K Williams, E Warburton, A L Kinmonth, J Mant, J Burt, C McKevitt

Abstract

Background: Self-rated health predicts health outcomes independently of levels of disability or mood. Little is known about what influences the subjective health experience of stroke survivors. Our aim was to investigate stroke survivors' perceptions of self-rated health, with the intention of informing the design of interventions that may improve their subjective health experience.

Methods: We conducted semi-structured interviews with a purposive sample of 28 stroke survivors recruited from a stroke unit and follow-up outpatient clinic, 4-6 months after stroke, to explore what factors are perceived to be part of self-rated health in the early stages of recovery. Qualitative data were analysed using a thematic analysis approach to identify underlying themes.

Results: Participants' accounts show that stroke survivors' perceptions of self-rated health are multifactorial, comprising physical, psychological and social components. Views on future recovery after stroke play a role in present health experience and are shaped by psychosocial resources that are influenced by past experiences of ill-health, dispositional outlook such as degree of optimism, a sense of control and views on ageing.

Conclusions: Severity of physical limitations alone does not influence perceptions of self-rated health among stroke survivors. Self-rated health in stroke survivors is a multidimensional construct shaped by changes in health status occurring after the stroke, individual characteristics and social context. Understanding the factors stroke survivors themselves associate with better health will inform the development of effective approaches to improve rehabilitation and recovery after stroke.

Keywords: Disability; Qualitative research; Rehabilitation; Self-rated health; Stroke.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for the study was obtained from the National Health Service (NHS East of England) – Norfolk REC (reference number: 11/EE/0108). We obtained written informed consent from all participants prior to taking part in interviews.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Factors influencing self-rated health in stroke survivors

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