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Title: Stroke, psychological outcomes and the self-regulatory model
Author: Evans, Sara
ISNI:       0000 0004 2693 8638
Awarding Body: Lancaster University
Current Institution: Lancaster University
Date of Award: 2008
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The present thesis examines psychological outcomes following stroke. Psychological distress is common following stroke and post-stroke depression has most frequently been studied. Associations between post-stroke depression and further adverse outcomes have been evidenced, including impaired physical recovery and even mortality. A need is highlighted for psychological factors associated with post-stroke distress to be identified that are modifiable and amenable to intervention. Associations between illness perceptions, or subjective beliefs regarding illness, and a range of health outcomes have been demonstrated across multiple chronic conditions. As such, illness perceptions are proposed as psychological constructs with the potential to further understanding of the subjective experience of stroke and psychological outcomes. The self-regulatory model (SRM), which theorises the dynamic relationship between illness perceptions and coping strategies in determining health outcomes, is advanced as an integrative framework for research examining post-stroke psychological adjustment. Research regarding cognitions compatible with the SRM is limited. However, promising findings are reviewed regarding the relationships between psychological outcome and perceptions of control, treatment and achieving a sense of meaning regarding stroke. On the basis of identified needs in the evidence base, a questionnaire-based study was undertaken employing the Illness Perception Questionnaire-Revised, a measure assessing all cognitive domains of the SRM, in a sample of people who had experienced stroke. Consistent with the SRM, coping strategies were also assessed, as were anxiety, depression and positive affect. It was hypothesised that illness perceptions and copingvariables would explain additional variance in psychological outcomes over that explained by previously implicated clinical and psychosocial variables. Illness perceptions or coping variables contributed significantly to each of the regression models of measured outcomes and the hypothesis was generally supported. The clinical implications of the research are discussed and the critical review expands on relevant issues, including situating illness perceptions in the context of existing psychological models
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available