Narrative therapy in reconstructing stroke survivors’ self-image and meaning of life

Abstract

Introduction: Cardiovascular disease (CVDs), such as stroke, is one of the most significant global health threats among elders. The experience of stroke not only has a significant impact on the physical functioning of stroke survivors (SSs), but also on their psychological well-being. While psychoeducational approach is incorporated as a common practice following stroke, evidences on its effectiveness are inconsistent and its mechanism remains unclear. According to the stress and coping theory (Lazarus & Folkman, 1984; Park and Folkman, 1997), the provision of stroke information to SSs may help to decrease the distress brought by the illness via regaining their meaning in life. Methodology: 192 SSs were recruited through the local stroke registries in Hong Kong and completed a questionnaire through home interview. The questionnaire assessed their cognitive functioning, physical impairment, subjective understanding to stroke, meaning in life, depressive symptoms and life satisfaction. Results: After controlling demographic characteristics, cognitive functioning, physical impairment, both subjective understanding of stroke and meaning in life predicted depressive symptoms and life satisfaction. Moreover, meaning in life mediated the effect of subjective understanding to stroke on depressive symptoms and life satisfaction. Conclusion: The findings supported the purposed framework of stress and coping theory. Compare with subjective understanding to stroke, meaning in life is a stronger predictor of depressive symptoms and life satisfaction among stroke survivors. Meaning-based intervention approach should be further explored for stroke survivors.