Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1701-1707, September 2008

Exploring Poststroke Mood Changes in Community-Dwelling Stroke Survivors: A Qualitative Study

Presented in part to the Stroke Society of Australasia, October 13, 2006, Adelaide, Australia.

  • Jennifer H. White, BAppSc(OT)

      Affiliations

    • Hunter Stroke Service, Hunter New England Area Health Service, New South Wales, Australia
    • Corresponding Author InformationReprint requests to Jennifer H. White, BAppSc(OT), Locked Bag No. 1, Hunter Region Mail Centre, NSW 2310, Australia
    • ,
  • Parker Magin, PhD

      Affiliations

    • Primary Health Care Research and Evaluation Development Program, University of Newcastle, New South Wales, Australia
    • ,
  • John Attia, PhD

      Affiliations

    • Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, New South Wales, Australia
    • ,
  • Michael R. Pollack, FAFRM

      Affiliations

    • Rankin Park Centre, Hunter New England Area Health Service, New South Wales, Australia
    • ,
  • Jonathan Sturm, PhD

      Affiliations

    • Gosford Hospital, Northern Sydney Central Coast Area Health Service, New South Wales, Australia
    • ,
  • Christopher R. Levi, FRACP

      Affiliations

    • John Hunter Hospital, Hunter New England Area Health Service, New South Wales, Australia

Abstract 

White JH, Magin P, Attia J, Pollack MR, Sturm J, Levi CR. Exploring poststroke mood changes in community-dwelling stroke survivors: a qualitative study.

Objective

To explore the long-term experience of mood changes in community-dwelling stroke survivors at 1, 3, and 5 years after stroke.

Design

A qualitative study using a modified grounded theory approach. The primary data collection method was semi-structured interviewing.

Setting

Community-dwelling stroke survivors in metropolitan Newcastle, NSW, Australia.

Participants

Twelve community-dwelling stroke survivors (6 men, 6 women; age range 43−92y; 4 participants from each cohort) discharged from a tertiary referral hospital.

Interventions

Not applicable.

Main Outcome Measures

Qualitative outcomes were participants' perceptions using in-depth, semi-structured interviews with participants from 3 community-based cohorts of stroke survivors at 1, 3, and 5 years poststroke.

Results

Four main categories of mood change were described by participants including feelings of frustration, reduced self-efficacy, dependency, and loss. Factors that modulated these mood changes included the presence or absence of insight, hope for the future, faith, and support. A modified grounded theory approach was used for data analysis using a process of constant comparison.

Conclusions

Mood changes continued well beyond discharge and in some cases commenced after discharge in this sample of stroke survivors. Use of qualitative methodology extends our understanding of the extent and nature of low mood after stroke. There is a need for enhanced services to monitor and address low mood.

Key Words: Cerebrovascular accident, Depression, Qualitative research, Rehabilitation

List of Abbreviations: ADLs, activities of daily living, DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, JHH, John Hunter Hospital, MMSE, Mini-Mental State Examination, MRS, Modified Rankin Scale, PSD, poststroke depression, QOL, quality of life, SIS, Stroke Impact Scale

 

 Supported by the Hunter Stroke Service, Hunter New England Area Health Service, NSW, Australia.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)00387-0

doi:10.1016/j.apmr.2007.12.048

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 9 , Pages 1701-1707, September 2008

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