Self-rated health predicts health outcomes independently of levels of disability or mood. Little is known about what influences the subjective health experience of stroke survivors. Our aim was to investigate stroke survivors’ perceptions of self-rated health, with the intention of informing the design of interventions that may improve their subjective health experience.
We conducted semi-structured interviews with a purposive sample of 28 stroke survivors recruited from a stroke unit and follow-up outpatient clinic, 4–6 months after stroke, to explore what factors are perceived to be part of self-rated health in the early stages of recovery. Qualitative data were analysed using a thematic analysis approach to identify underlying themes.
Participants’ accounts show that stroke survivors’ perceptions of self-rated health are multifactorial, comprising physical, psychological and social components. Views on future recovery after stroke play a role in present health experience and are shaped by psychosocial resources that are influenced by past experiences of ill-health, dispositional outlook such as degree of optimism, a sense of control and views on ageing.
Severity of physical limitations alone does not influence perceptions of self-rated health among stroke survivors. Self-rated health in stroke survivors is a multidimensional construct shaped by changes in health status occurring after the stroke, individual characteristics and social context. Understanding the factors stroke survivors themselves associate with better health will inform the development of effective approaches to improve rehabilitation and recovery after stroke.
Howell R, Kern M, Lyubomirsky S. Health benefits: meta-analytically determining the impact of well-being on objective health outcomes. Health Psychol Rev. 2007;1(1):83–136. CrossRef
Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;28(346):f167. CrossRef
Mavaddat N, Van der Linde R, Savva GM, Brayne C, Mant J. What determines the self-rated health of older individuals with stroke compared to other older individuals? A cross-sectional analysis of the Medical Research Council cognitive function and aging study. BMC Geriatr. 2013;13:85. CrossRefPubMedCentralPubMed
Hofstad H, Naess H, Gjelsvik BE, Eide GE, Skouen JS. Subjective health complaints predict functional outcome six months after stroke. Acta Neurol Scand. 2017;135(2):161–9.
Clarke P, Black SE. Quality of life following stroke: negotiating disability, identity, and resources. J Appl Gerontol. 2005;24(4):319–36. CrossRef
Folstein MF, Folstein SE, McHugh PR: "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12(3):189–198.
Government Department for Communities and Local Government: English Indices of Deprivation 2010. In.; 2011a.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5. PubMed
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. CrossRef
Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(3):1753–60.
van Woerden HC, Poortinga W, Bronstering K, Garrib A, Hegazi A. The relationship of different sources of social support and civic participation with self-rated health. J Public Mental Health. 2011;10(3):126–39. CrossRef
Mavaddat N, Valderas JM, van der Linde R, Khaw KT, Kinmonth AL. Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study. BMC Fam Pract. 2014;15:185. CrossRefPubMedCentralPubMed
Harrington J, Perry IJ, Lutomski J, Fitzgerald AP, Shiely F, McGee H, Barry MM, Van Lente E, Morgan K, Shelley E. Living longer and feeling better: healthy lifestyle, self-rated health, obesity and depression in Ireland. Eur J Pub Health. 2010;20(1):91–5. CrossRef
Perrig-Chiello P, Perrig WJ, Stahelin HB, Krebs-Roubicek E, Ehrsam R. Wellbeing, health and autonomy in old age: the basal IDA study (interdisciplinary aging study). Z Gerontol Geriatr. 1996;29(2):95–109. PubMed
Suls JM, C.A., Tobin, S. : The role of temporal comparison, social comparison and direct appraisal in the elderly's self-evaluations of health. J applied Soc Psychol 2006, 21(14):1125–1144.
Ferraro KF, Wilkinson LR. Alternative measures of self-rated health for predicting mortality among older people: is past or future orientation more important? Gerontologist. 2015;55(5):836–44.
Leventhal H, Idler E, Leventhal EA. The impact of chronic illness on the self system. In: Contrada RJ, Ashmore RD, editors. Self, social identity, and physical health. New York: Oxford University Press; 1999. p. 185–208.
Infurna FJ, Gerstorf D. Health Psychol. Perceived control relates to better functional health and lower cardio-metabolic risk: the mediating role of physical activity. 2014;33(1):85–94.
- Perceptions of self-rated health among stroke survivors: a qualitative study in the United Kingdom
A. L. Kinmonth
- BioMed Central
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