Abstract
While many studies focus on the impact of somatosensory changes on participation after stroke, they do not address the lived experience of all sensory systems (e.g., taste and smell). Researchers used a qualitative descriptive method using semistructured interviews to collect data. Results from this study could be utilized to inform healthcare providers about stroke survivors’ sensory needs and preferences to help them design interventions that match their needs.
Primary Author and Speaker: Dua'a Alwawi
Additional Authors and Speakers: Ashleigh Heldstab, Evan Dean, Winnie Dunn, Lisa Mische-Lawson
Sensory changes are common after stroke and identified by stroke survivors as an important area to consider in rehabilitation. Although motor recovery is highly dependent on sensory function, rehabilitation tends to focus on motor changes and neglects addressing sensory changes. Previous literature examined tactile and proprioceptive changes after stroke and its impact on occupational engagement (Tyson et al., 2008). While these studies focused on the impact of somatosensory changes on participation after stroke, they did not address the impact of changes in all sensory systems on participation (e.g., taste, smell), and how people adapt to these changes. The lived experience of sensory changes is a current gap in the research. This study seeks to fill the gap by answering three questions: 1. What sensory changes did individuals experience after a stroke? 2. How did sensory changes affect meaningful activities? 3. How did individuals cope with the sensory changes?
This study utilized a qualitative description method to gain an understanding of stroke survivors’ experience of sensory changes and how sensory changes impact participation in daily life activities. Researchers developed open-ended questions with probes to facilitate semi structured interviews. The interviews were recorded and transcribed verbatim. Researchers used an inductive content analysis approach adapted from Graneheim and Lundman (2004) to analyze the data gathered from the interviews.
We used purposive sampling to recruit thirteen stroke survivors who were 1-5 years past their stroke and participated in a community setting in an urban Midwestern city. Participants were both males and females younger than 75 years old.
Two major themes and six categories emerged from the data analysis to provide insight about the sensory changes participants experienced after stroke. The two themes included What sensory changes did I experience and when did they occur? and What are the occupations that have been impacted and how did I cope with these changes? The first theme consisted of three categories: Sensory function changes after stroke, Temporality and permanency of sensory changes, and Feelings and perceptions toward sensory changes. Three categories also comprised the second theme: occupations impacted, coping strategies, and amount of sensory-related therapy received. These categories and themes highlight the breadth and depth of sensory function changes occurring and their impact on participation in daily life.
Completion of this study provided insight about the impact of sensory changes people experienced after stroke on participation in everyday life activities. Changes in various sensory systems were reported including somatosensory, visual, auditory, taste and vestibular. Survivors also reported sensitivity to environmental stimuli as a major change they experienced after stroke. Participants confirmed that they didn’t receive enough therapy toward sensory changes which left them uncertain about the nature of these changes. However, participants reported that they used various coping strategies to deal with these changes including avoidance, preparation, acceptance, and tools’ replacement.
Results from this study could be utilized to inform health care providers about stroke survivors’ sensory needs and preferences to help them design interventions that match their needs. Furthermore, this information can be helpful to the person’s family, friends, and coworker; understanding the sensory changes individuals experience could help family members to modify the home environment to match person’s sensory needs. For instance, if a person experiences sensitivity to light after stroke, dimming the home lights would be helpful for the person to be productive.
Connell, L. A., McMahon, N. E., & Adams, N. (2014). Stroke survivors’ experiences of somatosensory impairment after stroke: An Interpretative Phenomenological Analysis. Physiotherapy, 100(2), 150-155. doi:10.1016/j.physio.2013.09.003
Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today, 24(2), 105-112. doi:10.1016/j.nedt.2003.10.001
Tyson, S. F., Hanley, M., Chillala, J., Selley, A. B., & Tallis, R. C. (2008). Sensory loss in hospital-admitted people with stroke: characteristics, associated factors, and relationship with function. Neurorehabilitation and Neural Repair, 22(2), 166-172. doi:10.1177/1545968307305523