Crisis Phenomena after Stroke Reflected in an Existential Perspective

Abstract

The study gains a deeper understanding of crisis phenomena emerging after stroke and focuses on these phenomena viewed in an existential perspective. Ten stroke victims narrated their experiences of their new life situation in open-ended interviews, conducted during the first few months after discharge. The participants were analyzed using a phenomenological-hermeneutic approach. This analysis disclosed an extremely distressing situation related to the individuals' struggle to manage in various dimensions of life. The phenomena were intertwined in a complex way and the critical interpretation involved a transcendence to the existential dimension of life. The situation was metaphorically depicted as “a struggle in the darkness” in a “boundary situation,” where the issues ultimately touched on life and death, fate and future, meaning and meaninglessness. The study indicates the significance of existential issues pervading the seemingly concrete struggle to manage life after stroke.

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References

Bakan

(1966). The duality of human existence. Chicago: Rand McNally.

Bauman

(1992). Mortality, immortality and other life strategies. Cambridge: Polity Press.

Becker

(1973). The denial of death. New York: The Free Press.

Bleicher

(1980). Contemporary hermeneutics. Hermeneutics as method, philosophy and critique. London: Routledge and Kegan Paul.

Castillo

Starkstein

Fedoroff

Price

, & Robinson

(1993). Generalized anxiety disorder after stroke. The Journal of Nervous and Mental Disease, 181, 100–106.

De Vries

(1990). Question mark? Reflexions on a medicine of spirit, mind and body. In Balner

(Ed.), A new medical model (pp. 66–78). Amsterdam: Amsterdam Swets & Zeit (Publications of the Helen Dowling Institute for Biopsychosocial Medicine).

Erikson

E. H.

(1982). The life cycle completed. A review. New York: W. W. Norton.

Folstein

M. F.

Folstein

S. E.

, & McHugh

P. R.

(1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.

Frankl

V. E.

(1985). Man's search for meaning: An introduction to logotherapy. New York: Washington Square Press (first published by Beacon Press: Boston, 1959).

10.

Gustafson

Olsson

Eriksson

Asplund

, & Bucht

(1991). Acute confusional states (delirium) in stroke patients. Cerebrovascular Diseases, 1, 257–264.

11.

Gustafson

Nilsson

Mattsson

Åström

, & Bucht

(1995). Epidemiology and treatment of post-stroke depression. Drugs and Ageing, 7, 298–309.

12.

Holbrook

(1982). Stroke: Social and emotional outcome. Journal of the Royal College of Physicians of London, 16, 100–104.

13.

Häggström

Axelsson

, & Norberg

(1994). The experience of living with stroke sequelae illuminated by means of stories and metaphors. Qualitative Health Research, 4, 321–337.

14.

Jaspers

(1919). Psychologie der Weltanschauungen. Berlin: Springer Verlag.

15.

Kishi

Koiser

, & Robinson

(1996). Suicidal plans in patients after stroke. The Journal of Nervous and Mental Disease, 184, 274–280.

16.

Kotila

Waltimo

Niemi

M.-L.

Laaksonen

, & Lempinen

(1984). The profile of recovery from stroke and factors influencing outcome. Stroke, 15, 1039–1044.

17.

Lindseth

Marhaug

Norberg

, & Udén

(1994). Registered nurses' and physicians' reflections on their narratives about ethically difficult care episodes. Journal of Advanced Nursing, 20, 245–250.

18.

Lyttkens

(1989). Disciplined man. (Swe.). Stockholm: Allmänna Förlaget.

19.

Mishler

E. G.

(1986). The analysis of interview-narratives. In Sarbin

T. R.

(Ed.), Narrative psychology. The storied nature of human conduct (pp. 233–255). London: Praeger.

20.

Nilsson

Jansson

, & Norberg

(1997). To meet with a stroke: Patients' experiences and aspects seen through a screen of crises. Journal of Advanced Nursing, 25, 953–963.

21.

Ricoeur

(1976). Interpretation theory: Discourse and the surplus of meaning. Fort Worth: Texas Christian University Press.

22.

Ricoeur

(1991). From text to action. Essays in hermeneutics, II. London: Athlone Press.

23.

Söderberg

Gilje

, & Norberg

(1997). Dignity in situations of ethical difficulty in intensive care. Intensive and Critical Care Nursing, 13, 135–144.

24.

The Holy Bible, The Scofield Reference Bible (1945). London: Oxford University Press.

25.

Tillich

(1952). The courage to be. New Haven: Yale University Press.

26.

Tillich

(1984). In LeFevre

(Ed.), The meaning of health. Essays in existentialism, psychoanalysis, and religion (pp. 168–169). Chicago: Exploration Press.

27.

Wade

Hewer

Langton R.

Skilbeck

, & David

(1985a). Stroke. A critical approach to diagnoses, treatment, and rehabilitation. London: Chapman and Hall.

28.

Wade

Wood

, & Hewer

Langton R.

(1985b). Recovery after stroke—The first 3 months. Journal of Neurology, Neurosurgery, and Psychiatry, 48, 7–13.