Resilience after Stroke: An Intervention to Promote Mental Health and Quality of Life among Older Stroke Survivors

Lead Research Organisation: King's College London
Department Name: Health and Social Care Research

Abstract

Stroke is the leading cause of adult disability (WHO 2009). The impact of stroke is often sudden, but may have a number of long term physical, mental and social consequences affecting individuals, families and carers. Older people and those from black ethnic groups have a higher risk of having a stroke (Heuschmann et al 2008). Since stroke can often be devastating, it is important to understand how people cope with its long term effects.

Resilience means an ability to ?bounce back? from an adverse event in life (Netuveli et al 2008), such as following a stroke. Being resilient to overcome adversity such as loss or illness in later life is associated with improved mental health and quality of life (Nygren et al 2005, Hildon et al 2009). However, we do not currently know what ?resilience? means to older people in terms of their ability to deal with the adverse consequences of a stroke.

This study aims to understand what ?resilience? means to older stroke survivors and their carers, and how resilience helps some people to recover and adapt to life after a stroke. This information will help us to develop new methods of supporting people with stroke in the long term. We will conduct interviews with older stroke survivors from white and black ethnic groups and their carers. We will also conduct focus groups with workers from health, social care and voluntary services, as well as policy makers in stroke care. We will then bring the results from these together to develop new methods of assisting older stroke survivors and carers to cope with the adverse effects of stroke. The results from the study will be presented at several conferences and published in a report and journal articles.

Technical Summary

Stroke is a long term condition affecting a significant proportion of adults in the UK, with the risk of stroke increasing with age and in black ethnic groups (Heuschmann et al 2008). It is the leading cause of adult disability (WHO 2009) and associated with substantially raised risk of depression (Hackett et al 2005). Resilience among older adults, defined as an ability to adapt positively, thrive or ?bounce back? from adversity such as loss and illness (Netuveli et al 2008) is associated with improved mental health and quality of life (Nygren et al 2005, Hildon et al 2009). However, it is currently not known what resilience resources, strategies and contexts may promote or hinder older stroke survivors? ability to cope with the adverse consequences of stroke. This study aims to investigate the meaning and role of resilience after stroke among older stroke survivors and their carers from white and black ethnic groups. The study uses qualitative interviews and focus group discussions to identify user and service providers? understandings of resilience and its relationship to recovery and adaptation after stroke. Using the Medical Research Council?s (MRC) guidance framework for complex interventions (MRC 2008), this information will then be used to develop a culturally appropriate intervention fostering resilience and thereby mental health and quality of life after stroke. We anticipate that this pilot work will lead in the future to the development of a larger randomised controlled trial to promote resilience after stroke for older stroke survivors and their carers.

Publications

10 25 50
 
Description Chair of Task & Finish Group for future role of NIHR Senior Investigators
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Description Clinical Academic Member of NIHR CCF group looking at Impact
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Title Focus group topic guide 
Description Focus group topic guide 
Type Of Material Database/Collection of Data/Biological Samples 
Provided To Others? No  
Impact data collection 
 
Title interview topic guide 
Description interview topic guide 
Type Of Material Database/Collection of Data/Biological Samples 
Provided To Others? No  
Impact used fordata collection 
 
Description 'Othering and Fitting into place: reflections arising from a social study of resilience after stroke' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Institute of Public Health, University of Cambridge "Beyond 'Them' & 'Us': Enacting social science within the public health research agenda on chronic illness", 18th September, Hughes Hall, University of Cambridge.

JISC-Mail forum established
Year(s) Of Engagement Activity 2012
 
Description Academic F1 keynote lecture: Transforming the Quality of Stroke Care: an Emergency & A Long Term Condition 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Keynote lecture given which led to questions and discussion.
Year(s) Of Engagement Activity 2016
 
Description ITN short film 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Programme for the Royal society of Public Health: Improve & Protect.
4 minute film including interviews with contributors
Year(s) Of Engagement Activity 2015
 
Description Poster presentation at ESOC Barcelona 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Poster presentations at the European Stroke Organisation Conference.
Year(s) Of Engagement Activity 2011,2012,2013,2014,2015
 
Description Resilience Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact BEYOND RESILIENCE: LEGACIES, LIMITS, FUTURES
King's College London
16th November 2012

Around 30 researchers from a range of disciplines participated with the aim of development of theory related to resilience
Year(s) Of Engagement Activity 2012
 
Description SLSR 20th anniversary Symposium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact SLSR20: 20 YEARS OF THE SOUTH LONDON STROKE REGISTER
Since 1995, the South London Stroke Register (SLSR) has recorded and followed up all first-ever strokes in people living in the south London boroughs of Lambeth and Southwark. It's the longest running register of its kind in the world.
This symposium celebrates the research made possible by the SLSR, its local and national policy impact, and the engagement of stroke survivors and carers.
Year(s) Of Engagement Activity 2015
 
Description Summer School talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Undergraduate students
Results and Impact Translational Research Summer School - talk given on 18th May 2017which resulted in discussion and questions.
Year(s) Of Engagement Activity 2016
 
Description User Workshop 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact Workshop on data collection methods

Used to inform data collection tools
Year(s) Of Engagement Activity 2012
 
Description presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited to present work to practitioners and researchers at University O Oldenburg, Germany to inform the development of their work on resilience in chronic illness.
Year(s) Of Engagement Activity 2014
 
Description social science workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Workshop with the social scientists in the KCL Stroke Research Group on 'Is resilience a useful construct for understanding the experiences of adjustment following stroke?' 12th April 2012

discussion used to inform interpretation of data in on-going narrative synthesis
Year(s) Of Engagement Activity 2012