Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Recovery Experiences of Adults with Mild Stroke: A Qualitative Analysis using a Self Determination Theory Approach (#166)

Swarna Vishwanath 1 , Natasha A Lannin 1 2 , Jan Cameron 3 , Olivia Brancatisano 3 , Dominique Cadilhac 3 , Nadine Andrew 4 , Sandy Reeder 1 , on behalf of the ReCAPs investigators 5
  1. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
  2. Alfred Health, Melbourne, Victoria, Australia
  3. Stroke and Ageing Research, Department of Medicine, Monash University, Melbourne, Victoria, Australia
  4. Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
  5. Other

Background: After a mild stroke, people are often discharged directly home, however, may continue to experience varying physical and psychological impacts from their stroke. These recovery experiences have seldom been captured.

Aims: To understand the factors that influence intrinsic motivation to recover from a mild stroke using self-determination theory (SDT).

Methods: Participants were from the Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke (ReCAPS) trial. 24 semi-structured interviews were conducted with stroke survivors who were between 3- and 12-months post-discharge from acute hospital following a mild stroke. All interviews were conducted one-on-one via telephone or video-conferencing. Thematic analysis was undertaken informed by SDT. Data were deductively coded to the three basic psychological needs (competence, autonomy, and relatedness) that underlie intrinsic motivation and wellbeing.

Results: Diverse factors impact motivation towards recovery in early stages after stroke, and participants rarely reported feeling fulfilled across all areas of psychological need. Some reported goal setting after stroke helped them feel in control of their recovery, however, others described feeling unable to identify something to work towards or feeling helpless about their situation, which diminished feelings of autonomy. Feeling competent at completing tasks that were able to be done pre-stroke was a source of motivation, but fatigue disheartened participants about their progress. Needs pertaining to relatedness supported motivations when family or friends helped them to achieve their goals, such as going for a daily walk. Participants were demotivated when family or friends challenged their goal progress, such as they were not willing  to change their behaviour to support a goal the participant set.

Conclusion: Results suggest most people did not perceive their needs were fulfilled across all three aspects of self-determination (competence, autonomy, and relatedness). Findings highlight opportunities to develop targeted interventions that could optimise an individual’s intrinsic motivation after stroke.