A qualitative analysis of the phenomena stroke survivors associate with post-stroke anxiety

Aims: The thesis had the broad aim of facilitating the development of theory that is grounded in the post-stroke context that begins to explain the phenomena of stroke-related anxiety. Specifically, it aimed to explore stroke survivors‟ views about factors they associated with their post-stroke anxiety. Literature Review: A review of literature into the prevalence rates for post-stroke anxiety disorders and the factors significantly correlated with post-stroke anxiety, found that research in this area was in its infancy. Limitations in studies undermined the reliability and validity of some findings. No prevalence rate could be given with any confidence for post-traumatic stress disorder (PTSD). However, evidence suggested a prevalence rate for general anxiety disorder (GAD) of between 20-28%. There was little evidence relating to other anxiety disorders. A relatively small number of studies identified a few factors significantly correlated with post-stroke GAD or PTSD. The evidence was strongest for GAD being comorbid with: depression, pre-morbid psychiatric history, reduced quality of life, and reduced social support. Methodology: The research adopted a qualitative approach, using semi-structured interviews to gather data from stroke survivors. The interview transcripts were analysed using Grounded Theory. Main findings: Participants associated factors with their anxiety that could be grouped into three main categories: dependence, vulnerability and inability to meet expectations. Participants expectations appeared linked to pre-stroke beliefs and experiences of the self and were used to compare with and judge their post-stroke experiences and identity over a prolonged period post-stroke. The relationship of anxiety with these phenomena could be explained with cognitive behavioural psychological theory. Adjustment to stroke related changes may have been delayed by unclear prognosis, vague expectations and slow rehabilitation that seem to be part of the pathway of post-stroke rehabilitation.