Defining Spiritual Wellbeing in Survivors of Stroke: A Convergent Parallel Mixed Methods Study

Stroke recovery involves adapting to physical impairments, emotional distress, and uncertainty about the future. Survivors of stroke may rely on spirituality and spiritual wellbeing practices to cope with illness. However, how survivors of stroke experience spiritual wellbeing remains unexplored. This study aimed to explore spiritual wellbeing in survivors of stroke and identify associated practices.

A convergent parallel mixed methods study using virtual focus groups with survivors of stroke and caregivers and survey data on spirituality using the All of Us research database was completed from October 2023 to February 2025. The framework method was used for qualitative data analysis and a 7-item spirituality survey completed by survivors of stroke was analyzed from the All of Us research database using descriptive statistics. Data sets were integrated through joint displays to assess coherence.

A total of 41 participants completed 6 focus groups. In this context, spirituality was defined as trust in a higher power and maintaining emotional balance. Focus groups identified spiritual wellbeing practices, including mindfulness, prayer, and spending time in nature. These findings converged with survey data (n=5428), with 70% of respondents endorsing connection with god/higher power. Spiritual practices extended beyond religious services, as 51.7% of respondents reported they did not attend religious services as a practice. Spending time in nature was a common practice, with 90.4% of respondents feeling spiritually touched by nature at least occasionally.

Spiritual wellbeing and its practices are important to survivors of stroke and can serve as a foundation for targeted interventions in poststroke care. Future research should investigate spiritual wellbeing in diverse populations to develop tailored interventions for survivors of stroke.