Patients' conceptions of their life situation within the first week after a stroke event: a qualitative analysis

The aim of this study was to find out how stroke patients conceived their life situation within the first week of the acute care phase as seen from the nurses' viewpoint. Six patients were interviewed within 3 weeks from their first stroke, using questions based on a holistic philosophy and analysed with the phenomonographic approach. Two main categories emerged from the results: the feeling of unreality and the awareness of a changed role in life, together with six subcategories; feeling of a changed perception of the body; feeling of being confused; loss of capability; awareness of confined life space; the importance of support and encouragement; and the will to look for new opportunities. The study concludes that the body change resulting from a stroke leads to both physical and psychological trauma, in which the psychological crisis can be very deep and best described as a personal catastrophe. The patient's capability to receive and understand information becomes blocked, which influences both the nurse and the patient's next of kin with regard to their care of the patient. Conversations with the patient must be frequent so that the acute care can be evaluated and agreement reached between the patient's wishes and the nurses' objectives. The results indicate the significance of intervention programmes based on crisis theory within the first week of a stroke event.