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Promoting psychosocial wellbeing following stroke using narratives and guided self-determination: a feasability study

Kirkevold, Marit; Martinsen, Randi; Bronken, Berit Arnesveen; Kvigne, Kari
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/193534
Date
2014
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  • Artikkel - fagfellevurdert vitenskapelig / Articles - peer-reviewed [3069]
Original version
Kirkevold, M., Martinsen, R., Bronken, B.A. & Kvigne, K. (2014). Promoting psychosocial wellbeing following stroke using narratives and guided self-determination: a feasability study. BMC Psychology, 2:4. doi: 10.1186/2050-7283-2-4   10.1186/2050-7283-2-4
Abstract
Background: Extensive studies have documented the complex and comprehensive psychosocial consequences

of stroke. Psychosocial difficulties significantly affect long-term functioning and quality of life. Many studies have

explored psychosocial interventions to prevent or treat psychosocial problems, but most have found modest effects.

This study evaluated, from the perspective of adult stroke survivors, (1) the content, structure and process and (2)

experienced usefulness of a dialogue-based psychosocial nursing intervention in primary care aimed at promoting

psychosocial health and wellbeing.

Methods: This was part of a feasibility study guided by the UK MRC complex interventions framework. It consisted

of dialogue-based encounters with trained health professionals during approximately the first year poststroke. It was

tested in two formats; individual or group encounters. Inclusion criteria were: Acute stroke, above 18 y.o., sufficient

physical and cognitive functioning to participate. Data were collected immediately before, during and 14 days after the

completion of the intervention. Pre- and post-data included medical and demographic data, quality of life, emotional

wellbeing, life satisfaction, anxiety and depression. Qualitative interviews focusing on participant experiences

were conducted two weeks following the intervention. Log notes taken by the health professionals conducting

the intervention and work sheets filled in by participants also comprised data. Data analysis was case-oriented.

The structured instruments were analysed regarding completeness of data and indication of changes in outcome

variables. The qualitative interviews, log notes and work sheets were analysed using thematic content analysis.

Results: Twenty-five stroke survivors (17 men, 8 women), median age 64 (range 33–89), participated. Physical

limitations varied from mild to severe. Seven participants had moderate to severe expressive aphasia. The participants

found the content and process of the intervention relevant. Both the individual and group formats were found useful.

Patients with aphasia reported that there were too few encounters (eight encounters were originally planned). The

participants underscored the benefits of being supported through a difficult time, having a chance to tell and (re)create

their story and being supported in their attempts to cope with the situation.

Conclusions: This study provides initial support for the usefulness of the psychosocial intervention and highlights areas

requiring further consideration and development.
Description
Vitenskapelig, fagfellevurdert artikkel
Publisher
BioMed Central
Journal
BMC Psychology

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