Adaptation and self-management after stroke: exploring the application of the Selection, Optimisation and Compensation model

Student thesis: Doctoral Thesis

Abstract

Background: Stroke can have long-term consequences for survivors, and recovery can be acomplex process. Unfortunately, there is a lack of theory-based evidence as to how stroke survivors can be aided in coping or adjusting to their new circumstances. The Selection, Optimisation and Compensation (SOC) model describes three processes of selection, optimisation and compensation, which are suggested to allow older adults to maintain activity in areas of life that are important to them, despite loss of functional or cognitive capacity. This thesis explored the Selection, Optimisation and Compensation (SOC) model as a model for post-stroke adaptation. Method: A mixed method approach consisted of systematically reviewing previous applications of the SOC model; conducting qualitative interviews with 30 stroke survivors to determine if SOC processes could be identified within coping strategies; and using Discriminant Content Validation (DCV) methodology to further analyse stroke-specific SOC strategies. Finally, the model was operationalised in the context of stroke through the development of a SOC self-management intervention, which was piloted with five stroke survivors. Findings: One hundred and forty nine stroke-specific SOC strategies were elicited from the interviews; 78% of which were significantly classified as at least one of the theoretical constructs of SOC using DCV analysis.Such findings were used to develop a SOC self-management intervention, which included descriptions of the SOC processes and examples of stroke-specific SOC strategies. Discussion: Overall, this thesis provided strength to the argument that the SOC model is indeed appropriate for the aim of helping stroke survivors come to terms with living with the long-term consequences of stroke. Further refinements are, however, necessary in the operationalisation of the SOC model into a post-stroke intervention. Future research should build upon these findings in order to increase the effective use of SOC strategies; with the ultimate aim of improving adaptation in stroke survivors.
Date of Award1 Jun 2016
LanguageEnglish
Awarding Institution
  • University Of Strathclyde
SupervisorMadeleine Grealy (Supervisor) & Diane Dixon (Supervisor)

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