Triumphs and trials surrounding secondary stroke preventive care in women stroke survivors: A qualitative study

BackgroundWomen stroke survivors may face unique challenges when navigating life after stroke, particularly when engaging in stroke preventive care.ObjectiveWe examined the barriers and facilitators to receiving adequate secondary stroke preventive care among Canadian women stroke survivors.DesignA qualitative descriptive analysis was conducted.MethodsWe undertook a secondary analysis of a study on participants who had survived a stroke within the previous year, were able to walk unassisted, and did not reside in a long-term care home, recruited from one of the five stroke prevention clinics across Toronto, Ontario. This sub-analysis focused on women stroke survivors. Semi-structured interviews were conducted by trained interviewers. Using a qualitative descriptive approach, we analyzed the transcribed interviews to identify themes describing participants' engagement in secondary stroke prevention.ResultsIn total, 10 women aged 63 to 84 years, seven of whom were immigrants, were included. We identified three major themes: (1) medication-taking was driven more by authority and obligation than by clear understanding, (2) adherence was supported through familiar routines, household practices, and social reminders, even when medications caused discomfort, (3) women experienced "hidden loneliness," as shifts in relationships, caregiving roles, and expectations of self-reliance shaped their engagement in preventive care. Social expectations and intersecting roles influenced how women engaged in stroke preventive care, with those with strong social networks and familiar healthcare providers showing improved engagement in stroke preventive care.ConclusionsDespite limited information and shifting social identities, women drew on daily routines, trusted providers and social networks to sustain preventive behaviours. Interventions to improve secondary stroke preventive care in women stroke survivors should focus on improving autonomy through improved knowledge and simplified routines.