Seeking connectedness post-stroke: an existential perspective on lived experiences of working-age men using grounded theory

Stroke, or cerebral vascular accident (CVA), is a type of acquired brain injury (ABI). It is a leading cause of disability, with over 1.2 million survivors currently living in the UK. Age at onset has dropped over recent decades, with men at higher risk of having stroke at a younger age than women. The biomedical model is crucial for stroke survival. However, psychosocial factors in determining progress with rehabilitation have been increasingly recognised, along with stroke literature pointing towards the (less widely acknowledged) significance of existential factors. Ten male stroke survivors of working age with mild to moderate stroke-related impairments were recruited through noticeboard advertising at a branch of Headway (a leading ABI charity). Participant ages at onset of stroke ranged from 38 to 60 years, with time post-injury ranging from 1 to 10 years. Participants were individually interviewed using a semi-structured interview schedule. Analysis of the interview data was guided by grounded theory methods described by Corbin and Strauss. The theoretical model generated from the data outlines a process comprising three components: ‘experience’ of enduring otherness, which can lead to ‘outcome’ of experiencing belongingness, through ‘action’ of seeking connectedness (which was selected as the core category of the theoretical model). Furthermore, this process of seeking connectedness unfolds across four domains of lived experience; namely, the physical, psychological, social, and the philosophical, with each domain having dimensionality of alienation vs. integration; acceptance-resignation vs. defiance; isolation vs. participation; and pointlessness vs. meaningfulness, respectively. The model goes beyond the biopsychosocial perspective to include an existential viewpoint (under the philosophical domain). Rather than being diagnoses-focused, the model offers a framework for a formulation-based understanding of lived experiences and meaning-making for working-age male stroke survivors. Further work is required to ensure the validity of the model and its applicability to a wider stroke population.