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Title: Couples facing adversity through stroke and malignant brain tumour : a qualitative investigation
Author: Betts, S.
ISNI:       0000 0004 7969 5625
Awarding Body: University of Exeter
Current Institution: University of Exeter
Date of Award: 2019
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Literature review: Objectives: Historically most qualitative research on the couple experience of stroke has focused on the negative impact, including reviews that outline challenges for couple's communication, roles and intimacy. The current review aims to examine the perceived positive impact of stroke on couple relationships from the perspective of stroke survivors and spouses. Methods: Relevant qualitative literature was identified through systematic searching of the databases Medline, PsycInfo and EMBASE. Thirty-two articles met the inclusion/exclusion criteria. The articles were appraised using the Critical Appraisal Skills Programme tool and a thematic synthesis was conducted on the findings from these articles. Results: Ten descriptive and three analytical themes were identified. The analytical themes showed a strengthening of the couple bond, an enhanced way of couple's relating and empowerment of the spousal caregiver in the stroke survivor's recovery. Conclusions: The review identifies that couples can engage with dyadic coping and enhance their pre-stroke relationship through the experience of stroke. Rehabilitation staff, inclusive of clinical psychologists, can play an important role in engaging and empowering couples to recognise and utilise their strengths and resilience. Future research could examine how rehabilitation can utilise these findings in practice and the efficacy of couple's therapy in this population. Empirical paper: Abstract Objectives: To explore the impact of relational dynamics on couples impacted by malignant brain tumour, with the aim of expanding the knowledge we have about the impact of brain tumour from the perspective of the patient, carer and couple. The current research gives a different perspective of the relational impact of this illness through use of discourse analysis and joint interviews. Methods: Six heterosexual couples took part in the research which involved conducting joint semi-structured interviews with the couple in their homes. The interviews were analysed using a discourse analysis approach to observe how the couples constructed meaning about their shared experience of a brain tumour and its impact on the couple relationship. Results: Couples used rhetorical strategies, such as humour and deflection, to ease discomfort and navigate the sensitive topic. Discourses used by both partners highlights that the journey can be one of isolation, despite the presence of a partner. In contradiction, the couple were often positioned together, against the brain tumour itself, in a position of dyadic coping. Conclusions: Conversations about the impact of brain tumour are highly sensitive. As a result, couples implement strategies in order to communicate their difficulties, their distress and challenging elements such as death and uncertainty of the future. Clinical implications are offered for how health care professionals facilitate discussions between couples and how the dynamic between a couple can be supported in hospitals, rehabilitation and in the community.
Supervisor: Smith, A. ; Smithson, J. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available