Beyond the Clinic: How Stroke Survivors Navigate Secondary Prevention Through Situated Agency

Area of Science:

• Neurology
• Public Health
• Qualitative Research

Background:

• Secondary stroke prevention is vital for reducing stroke recurrence.
• Real-world engagement with secondary preventive care among stroke survivors is not well understood.

Purpose of the Study:

• To explore barriers and facilitators influencing stroke survivors' engagement in secondary preventive care.
• To understand the lived experiences of stroke survivors in the Greater Toronto Area regarding stroke prevention.

Main Methods:

• Qualitative study employing semi-structured interviews with 25 stroke survivors (first-ever stroke within one year, low/moderate disability).
• Interpretive descriptive analysis of transcribed interviews conducted in three languages.
• Exploration of experiences based on immigration status, presenting integrated themes.

Main Results:

• Seven core themes emerged: self-reliance in recovery, knowledge gaps in stroke risk/prevention, barriers to preventive behaviors, system navigation challenges, impact of social networks, assumptions about self-management, and the desire for dignity/agency.
• Patient actions are shaped by broader structural and relational contexts, analyzed through situated agency.

Conclusions:

• Stroke survivors' engagement with preventive care is influenced by their context and actions within it.
• A situated agency framework can inform interventions to enhance engagement and decrease stroke recurrence.