How does a cerebral stroke affect quality of life? Towards an adequate theoretical account.

Abstract

To contribute, through a hypothesis-generating, qualitative study, to a consistent theoretical account of the mechanisms by which strokes affect the quality of lives of patients. A strategic subsample of six persons (65-85 years) was drawn from a larger sample of 60 stroke patients 3 years after stroke. They suffered from some, mostly mild, motor or cognitive impairments, and underwent a semi-structured interview, which was tape-recorded, transcribed and analysed. Only one of the subjects had any familiarity with the QoL concept. When it was rephrased in familiar terms, all but one stated that their QoL had been reduced after the stroke. All the subjects reported considerable bodily changes. The reduced QoL was not, however interpreted as a direct consequence of these, but as a result of the individual's interpretation and evaluation of the changes. It was essential whether the patient compared the present situation to life prior to the stroke, or to a post-stroke reference point. These personal evaluations interacted with the interpretations of the situation by the patients' significant others.