Evidence map›Paper›PMID 34388983›Full record

ArticleBMC neurology2021

What underlies the difference between self-reported health and disability after stroke? A qualitative study in the UK.

Nahal Mavaddat, Euan Sadler, Lisa Lim, Kate Williams, Elizabeth Warburton, Ann Louise Kinmonth, Chris Mckevitt, Jonathan Mant

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In one paragraph

Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nahal MavaddatSchool of Medicine, Division of General Practice, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia. nahal.mavaddat@uwa.edu.au.ORCID http://orcid.org/0000-0001-6597-2597
Euan SadlerDepartment of Nursing, Midwifery and Health, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Lisa LimDepartment of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Kate WilliamsDepartment of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Elizabeth WarburtonDepartment of Clinical Neurosciences, Neurology Unit, University of Cambridge, R3, Box 83, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
Ann Louise KinmonthDepartment of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Chris MckevittSchool of Population Health and Environmental Sciences, King's College London, Addison House, London, SE1 1UL, UK.
Jonathan MantDepartment of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLevels of self-reported health do not always correlate with levels of physical disability in stroke survivors. We aimed to explore what underlies the difference between subjective self-reported health and objectively measured disability among stroke survivors.

methodsFace to face semi-structured interviews were conducted with stroke survivors recruited from a stroke clinic or rehabilitation ward in the UK. Fifteen stroke survivors purposively sampled from the clinic who had discordant self-rated health and levels of disability i.e. reported health as 'excellent' or 'good' despite significant physical disability (eight), or as 'fair' or 'poor' despite minimal disability (seven) were compared to each other, and to a control group of 13 stroke survivors with concordant self-rated health and disability levels. Interviews were conducted 4 to 6 months after stroke and data analysed using the constant comparative method informed by Albrecht and Devlieger's concept of 'disability paradox'.

resultsIndividuals with 'excellent' or 'good' self-rated health reported a sense of self-reliance and control over their bodies, focussed on their physical rehabilitation and lifestyle changes and reported few bodily and post-stroke symptoms regardless of level of disability. They also frequently described a positive affect and optimism towards recovery. Some, especially those with 'good' self-rated health and significant disability also found meaning from their stroke, reporting a spiritual outlook including practicing daily gratitude and acceptance of limitations. Individuals with minimal disability reporting 'fair' or 'poor' self-rated health on the other hand frequently referred to their post-stroke physical symptoms and comorbidities and indicated anxiety about future recovery. These differences in psychological outlook clustered with differences in perception of relational and social context including support offered by family and healthcare professionals.

conclusionsThe disability paradox may be illuminated by patterns of individual attributes and relational dynamics observed among stroke survivors. Harnessing these wider understandings can inform new models of post-stroke care for evaluation.

Indexed as

Self ReportStrokeStroke RehabilitationAgedAged, 80 and overDisability EvaluationFemaleHumansMaleMiddle AgedSurvivorsUnited KingdomStroke self-reported health quality of life disability

Identifiers

PMID34388983
PMCPMC8362227

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.