A stroke of grief and devotion: A hermeneutic enquiry of a family’s lived experience two years post-stroke

Abstract
The purpose of this hermeneutic enquiry was to explore the lived experiences of family members over the first two years after a person’s first-time stroke. A stroke can have significant consequences for the person surviving a stroke and their family, causing altered life experiences and responsibilities. Consequences differ according to stroke type, location and severity with varying effects on the experiences of families’ post-stroke. This study was part of a larger four-year longitudinal hermeneutic phenomenological inquiry, informed by the writings of van Manen, aimed at improving support and outcomes for stroke survivors and their families. The parent project recruited five families in 2011 from a city hospital in Aotearoa New Zealand, with one family of four participants agreeing to participate in this particular study. Participants included the stroke survivor's spouse (primary caregiver), two of her adult children and the partner of one of these (n=4). A series of three semi-structured interviews with all participants occurred at six weeks, and at one and two years poststroke. Data were analysed thematically. The findings revealed that stroke can have life-altering consequences for the stroke survivor and their family. This research highlighted the lived experience of a family two years post-stroke and the variation in experience over time and between participants. Our participants experienced shock, continual change, and deepening devotion with far-reaching implications. We recommend completing family assessments to determine a family's post-stroke situation and their capacity and desire to participate in the care as well as enhancing communication and information provision. Nurses and other health professionals must ascertain the needs of stroke survivors and families and provide family-oriented care that is regardful of their needs. Care provision should be flexible and provided across all phases of the post-stroke trajectory, including up to two years post-stroke. 

Ngā ariā matua
Ko te whāinga o tēnei uiuinga whakamārama he tūhura i ngā wheako mō te rua tau o tētahi whānau i muri i te īkura roro tuatahi o tētahi tangata. He nui ngā pānga o tēnei mea te īkura roro mō te tangata ka ora ake i te īkura, me ō rātou whānau, e huri katoa nei ngā āhuatanga o te noho me ngā tūranga mahi. He rerekē ngā tukunga iho, i runga anō i te momo īkura, te takiwā, me te taumaha o te īkura, me te rerekē o ngā pānga ki ngā wheako o ngā whānau i muri i tētahi īkura roro. Hei wāhanga tēnei o tētahi uiuinga whakamārama mō te whā tau, e whakawhirinaki ana ki ngā tuhinga a van Manen, e anga nei ki te whakapiki i te tautoko me ngā putanga pai mō ngā tāngata ka ora ake i tētahi īkura roro me ō rātou whānau. Nā te kaupapa i noho matua ki tēnei uiuinga i kimi ētahi whānau e rima mai i 2011 mai i tētahi hōhipera tāone nui i Aotearoa, me te whakaae hoki o tētahi whānau, e whā te hunga whai wāhi, kia uru ki tēnei rangahau ake. Kei waenga i te hunga whai wāhi ko te hoa wahine o te tangata i ora ake i te īkura roro (kaitiaki matua), tokorua ōna tamariki taipakeke, me te hoa o tētahi o ēnei (n=4). I tū ētahi uiuinga e toru, i āhua whakamaheretia, i te ono wiki i muri, tētahi kotahi tau i muri, te tuatoru i te rua tau i muri mai i te īkura roro. I tātaritia ngā raraunga mō ngā ariā. E ai ki ngā kitenga ka mōhiotia he nui ngā putanga whakarerekē i te noho mō te tangata ka ora ake i te īkura roro me tana whānau. Nā ēnei rangahau i whakatairanga ngā wheako mō te rua tau o tētahi whānau i muri i tētahi īkura roro me te rerekētanga o te noho i roto i taua wā i waenga i te hunga whai wāhi. I pā te ohorere, te huringa mutunga kore, me te hōhonutanga atu o te ngākau aroha tētahi ki tētahi, me ngā pānga tino hōhonu anō hoki. E tūtohu ana mātou kia whakaotingia ētahi aromatawai ā-whānau hei whakatau i te noho o tētahi whānau i muri i tētahi īkura roro, me te hiahia kia whai wāhi ki ngā atawhainga, tae atu ki whakapiki i te whakawhitinga kōrero me te horanga mōhiotanga. Me tahuri ngā tapuhi me ērā atu kaitiaki hauora ngaiao ki te tautohu i ngā hiahia o te hunga kua ora ake i tētahi īkura roro me ō rātou whānau, me te hora manaakitanga e tino hāngai ana ki ō rātou hiahia. Kia pīngawingawi kia tika ngā mahi tiaki, kia māhorahora te tuku i ngā wāhanga katoa o te tiaki i te oranga ake i muri i te īkura roro, tae atu ki te rua tau i muri i te īkura roro.

Keywords / Ngā kupu matua
carers / ngā kaitiaki; family / whānau; hermeneutic / whakamārama; lived experience / wheako tūturu; longitudinal / wā-roa; phenomenology / āhuatanga ka kitea; qualitative research / rangahau kounga; stroke / īkura roro