Abstract

Introduction: Stroke self-management (SM) interventions have demonstrated beneficial effects for improving function and stroke outcomes. Little is known about how and what make positive behavioral change (or not) for SM participation and adherence. Objectives: To explore, from first-time stroke survivors’ perspectives, the perceived role, facilitators and barriers of stroke SM, and how they deal with day-to-day stroke SM. Methods: This qualitative study was embedded in a randomized controlled trial aimed at investigating the effects of a stroke SM program on functional and psychosocial outcomes. All participants in this study, being involved in the intervention group of the trial, were purposively selected based on their SM behavioral change post-intervention. Maximum variation principles, including age, sex and ADL were adopted for participants’ recruitment. Interview data were audio taped, transcribed verbatim and entered into NVIVO 10 for content analysis. Results: Findings from 20 stroke informants (age range 41-85, 65% male, ADL score range 65 - 100) revealed three categories including (1) perception of stroke self-management (medical and behavioral management; role management; emotional management, stroke knowledge management), (2) facilitating factors (knowledge and skills established; fear of stroke recurrence; family, professional and peer support; and personal meaningful goals and action plan), and (3) barriers (extent of negative impact of stroke; economy-related factors; environment-related factors; and powerlessness to stroke). Conclusions: Stroke participants described approaches that facilitated their SM, and identified barriers that may be amenable to SM counseling strategies for enhancing resilience for SM participation and adherence.

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