Abstract
Coping strategies are found to predict success in rehabilitation. Research is lacking in identifying the specific coping strategies used to adjust to sensory changes. This study seeks to understand how individuals handle sensory changes after stroke. Researchers used a qualitative descriptive method using semistructured interviews to collect data. Results from this study can be utilized to inform OTs about what strategies are being used by stroke survivors to cope with sensory changes.
Primary Author and Speaker: Dua’a Alwawi
Additional Authors and Speakers: Ashleigh Heldstab, Evan Dean
Stroke is a major event in an individual’s life that has far-reaching consequences. Researchers reported that post-stroke sensory changes have a noticeable impact on survivors’ ability to participate in daily activities. Stroke survivors have used various strategies to deal with changes after stroke and re-engage in activities that have been affected due to these changes. Coping is a single or set of strategies used to handle a stressful situation. Coping strategies found to predict success in rehabilitation. Research is lacking in identifying the specific coping strategies used to adjust to sensory changes. This study seeks to understand how individuals handle sensory changes after stroke. These ideas were addressed with the following research question: How did individuals cope with the sensory changes?
This study utilized a qualitative description method. 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. Trustworthiness was established by addressing credibility, transferability, dependability, confirmability, and authenticity.
One major theme and six categories emerged from data analysis to provide insight about the many strategies used to cope with the large breadth and depth of sensory changes. The Ecology of Human Performance (EHP; Dunn, Brown, & McGuigan,1994) framework was used to guide the organization of coping strategies. Four coping strategies were adapted from the therapeutic interventions in the EHP; establish/ restore; modify; alter, and prevent. Two additional coping strategies that did not fit within the EHP interventions were identified. Participants reported establishing new routines and restoring individual abilities (establish/restore), adapting the environment and task demands to best support their performance despite sensory changes (adapt), finding a better match between their sensory preferences and an environment will better support their performance (alter), and anticipating the aversive stimuli and preparing themselves to avoid negative outcomes related to sensory changes (prevent/think ahead). Finally, participants described two additional strategies: social support and avoidance. Many participants shared the importance of the support system to cope with sensory changes as well as avoiding aversive sensory stimuli in the environment.
Results from this study can be utilized to inform occupational therapists about what strategies are being used by stroke survivors to cope with sensory changes so that similar strategies can be implemented in therapy. These strategies are inherently person-centered as they are being identified and implemented by the survivors themselves. So, rehabilitation in early stages of recovery can help stroke survivors to identify the adaptive coping strategies and the impact of these strategies on their quality of life.
Dunn, W., Brown, C., McGuigan, A. (1994). The Ecology of Human Performance: A Framework for Considering the Effect of Context. American Journal of Occupational Therapy, 48(7), 595-607. doi: 10.5014/ajot.48.7.595
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