Exploring the experience of cognitive changes among community-dwelling stroke survivors: a qualitative study

Abstract

Purpose

Cognitive deficits are common among stroke survivors and impact their functional independence. Despite the prevalence of cognitive deficits after stroke, cognitive function is largely overlooked in post-stroke care. The aim of this qualitative study was to explore the experiences of individuals living with post-stroke cognitive changes to understand the impact of these changes on their daily lives.

Materials and Methods

Semi-structured interviews were conducted with a purposeful sample of thirteen community-dwelling adults 50 years and older with chronic stroke who self-identified cognitive changes post-stroke. Interviews were transcribed and an inductive thematic analysis was completed.

Results

Four key themes were identified: 1) inability to maintain everyday activities; 2) experiencing emotional responses to living with post-stroke cognitive changes; 3) a shrinking social world and; 4) seeking care for cognitive health post-stroke.

Conclusions

Post-stroke cognitive changes were described by participants as a driving force behind negative shifts in their daily lives, emotional health, and social connections after stroke. Despite seeking care for their post-stroke cognitive changes, many participants were unable to find support in mainstream healthcare. There is a demonstrated need to further elucidate the gaps in care for post-stroke cognitive deficits and implement community interventions targeting cognitive health post-stroke.

IMPLICATIONS FOR REHABILITATION

• Clinicians should consider how cognitive changes post-stroke may affect daily life and the uptake in support services to help improve accessibility and alter the delivery of care accordingly.

• Clinicians should regularly complete cognitive screenings among their clients living with stroke and probe them for the effects of cognitive deficits within their daily life.

• There is a demonstrated need for community interventions that target cognitive health for individuals living with stroke, and clinicians should consider advocating for and spearheading such programs within the community.

Keywords:

• Stroke
• cognition
• cognitive deficits
• qualitative
• lived experience

Acknowledgements

KJB held a CGS-M SSHRC Award. JCD is a Michael Smith Foundation for Health Research Career Scholar and a Canada Research Chair (Tier II) in Applied Health Economics. JJE is a Canada Research Chair (Tier I) in Neurological Rehabilitation. TLA is a Canada Research Chair (Tier I) in Healthy Aging.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Due to the nature of this research, data is not publicly available to preserve participant anonymity.

Additional information

Funding

Funding for this study was provided by the Jack Brown and Family Alzheimer Research Foundation Society and the Canadian Institute for Health Research (MOP-126130) to TLA.