The exploration of self-regulation and transfer anxiety within stroke patients transferred from a hyper acute stroke unit to a ward

Brooke, Joanne (2013) The exploration of self-regulation and transfer anxiety within stroke patients transferred from a hyper acute stroke unit to a ward. Doctoral thesis, London Metropolitan University.

Abstract

Stroke services provide patients with immediate assessment and treatment on a hyper acute stroke unit prior to being transferred for intense rehabilitation. Patients' experience of transfer from a hyper acute stroke unit has yet to be explored. A patient's beliefs regarding their illness are important factors that aid a patients' recovery yet these have not been fully explored in patients following a stroke. The aims of this study are to explore the patients' perspectives of transfer from a hyper acute stroke unit to a stroke unit and their itIness beliefs. Data were collected from a purposive sample of patients (n=6) on a stroke unit following transfer from a hyper acute stroke unit. Semi-structured interviews were carried out to explore patients' experience of transfer and their illness beliefs. The interview schedule was based on literature and interviews with a Clinical Nurse Specialist and a stroke patient. Data were analysed using Interpretative Phenomenological Analysis (IPA). The emergent super-ordinate themes included: disassociation from being in the world, search for understanding. strive for independence and acceptance of support, and hope and uncertainty. A chronic illness model of illness representation dimensions emerged; higher reporting of identity, consequences, and timel ine was associated with lower personal and treatment control and an emotional response. Self-regulatory coping strategies and health beliefs within patients following a stroke were identified as important constructs to include in healthcare assessments with the aim of improving psychological, physical and social outcomes.

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