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Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study.

Publication ,  Journal Article
Harris Walker, G; Gonzalez-Guarda, R; Yang, Q; Shah, S; Prvu Bettger, J
Published in: J Adv Nurs
June 2021

AIMS: Stroke is affecting an increasing number of young and middle-aged adults. Given the substantial diversion from anticipated life trajectories that younger stroke survivors experience as a result of their stroke deficits, their health-related quality of life (HRQOL) is likely to be negatively impacted during the immediate post-acute recovery period. The aim of this study was to generate a comprehensive understanding of the influences on HRQOL and acute recovery during the first three months following stroke for younger adults using a socio-ecological perspective. DESIGN: Longitudinal, convergent mixed methods design. METHODS: HRQOL survey data, assessed using the Patient Generated Index (N = 31), and qualitative interview data about survivors' recovery experiences (N = 20) were collected. Simple linear regression and effect size results were integrated with themes and sub-themes identified from conventional content analysis using joint data displays. RESULTS: Depression and fatigue negatively affected recovery at the individual level. At the family and societal level, family functioning, social support including being married, having insurance, working, adequate income and being unemployed post-stroke all positively impacted recovery. Qualitative findings revealed determination, coping, and accessing healthcare to positively affect recovery though a meta-inference could not be drawn as no quantitative data addressed these concepts. CONCLUSION: A variety of factors intersecting across socio-ecological levels were perceived by young stroke survivors to influence acute recovery experiences and outcomes. IMPACT: This study identified individual-, family- and societal-level factors in younger adults' environments that may affect the acute stroke recovery experience. Findings underscore the need for research and clinical approaches that consider environmental factors at multiple levels of influence when supporting stroke recovery for younger adults.

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Published In

J Adv Nurs

DOI

EISSN

1365-2648

Publication Date

June 2021

Volume

77

Issue

6

Start / End Page

2860 / 2874

Location

England

Related Subject Headings

  • Survivors
  • Stroke Rehabilitation
  • Stroke
  • Social Support
  • Quality of Life
  • Nursing
  • Middle Aged
  • Humans
  • Adult
  • 4205 Nursing
 

Citation

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Harris Walker, G., Gonzalez-Guarda, R., Yang, Q., Shah, S., & Prvu Bettger, J. (2021). Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study. J Adv Nurs, 77(6), 2860–2874. https://doi.org/10.1111/jan.14778
Harris Walker, Gabrielle, Rosa Gonzalez-Guarda, Qing Yang, Shreyansh Shah, and Janet Prvu Bettger. “Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study.J Adv Nurs 77, no. 6 (June 2021): 2860–74. https://doi.org/10.1111/jan.14778.
Harris Walker G, Gonzalez-Guarda R, Yang Q, Shah S, Prvu Bettger J. Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study. J Adv Nurs. 2021 Jun;77(6):2860–74.
Harris Walker, Gabrielle, et al. “Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study.J Adv Nurs, vol. 77, no. 6, June 2021, pp. 2860–74. Pubmed, doi:10.1111/jan.14778.
Harris Walker G, Gonzalez-Guarda R, Yang Q, Shah S, Prvu Bettger J. Socio-ecological perspective on factors influencing acute recovery of younger stroke survivors: A mixed methods study. J Adv Nurs. 2021 Jun;77(6):2860–2874.
Journal cover image

Published In

J Adv Nurs

DOI

EISSN

1365-2648

Publication Date

June 2021

Volume

77

Issue

6

Start / End Page

2860 / 2874

Location

England

Related Subject Headings

  • Survivors
  • Stroke Rehabilitation
  • Stroke
  • Social Support
  • Quality of Life
  • Nursing
  • Middle Aged
  • Humans
  • Adult
  • 4205 Nursing