Article

Although stroke is associated with ageing, a significant proportion of
strokes occur in younger people. Younger stroke survivors have experienced care
available as inappropriate to their needs. However, insufficient attention has
been paid to how the social context shapes their experiences of care. We
investigated this question with younger stroke survivors in Greater London, UK.
METHOD: We conducted in-depth interviews with individuals aged between 24 and 62
years. Interviews were analysed thematically, with interpretation informed by
Bourdieu's concepts of field, capital and habitus. RESULTS: In the acute care
setting it was implicit for participants that expertise and guidance was to be
prioritised and largely this was reported as what was received. Individuals'
cultural capital shaped expectations to access information, but health care
professionals' symbolic capital meant they controlled its provision. After
discharge, professional guidance was still looked for, but many felt it was
limited or unavailable. It was here that participants' social, cultural and
economic capital became more important in experiences of care. CONCLUSIONS: The
field of stroke shaped younger stroke survivors' experiences of care. Navigating
stroke care was contingent on accessing different forms of capital. Differences
in access to these resources influenced longer term adjustment after stroke.
IMPLICATIONS FOR REHABILITATION: Stroke care can be conceptualised as a temporal
field of social activity and relationships which shapes variations in experiences
of care among younger stroke survivors, and differences in expectations of
support at different time points after stroke. On entering the field of stroke
participants reported needing health care professional guidance and expertise to
manage the acute event, yet difficulties accessing information in hospital
limited the agency of some individuals wanting to take an active role in their
recovery. After discharge from hospital variations in experiences of care among
participants were more evident, with a number still seeking professional
guidance, and requiring the capital and agency to navigate the field of stroke.
Despite international efforts to improve the quality of acute care, effective
models of community stroke care still need to be developed.

Langue : ANGLAIS