title: Stroke and eating difficulties: long-term experiences.
abstract: BACKGROUND
  Previous studies have shown that eating difficulties after stroke are common and often associated with communication problems. These difficulties, however, have mainly been studied from a professional perspective. Although numerous aspects of dysfunction have been identified, little knowledge exists about the experiences of living with eating difficulties.
  
  
  OBJECTIVE
  To explore how people affected by stroke experience living with eating difficulties, during a prolonged period.
  
  
  METHODS
  Explorative, qualitative case study.
  
  
  METHODS
  Repeated interviews and participant observations with three persons 1.5-2 years after their last stroke. Data were analysed using qualitative analysis.
  
  
  RESULTS
  Eating difficulties after stroke were experienced as Striving to live a normal life, with the subthemes Abandoned to learn on one's own, Experiences of losses and Feeling dependent. The process of getting back to a life that resembled life before the stroke was experienced as long-lasting and hard work. The informants felt that they were abandoned to manage eating training on their own. The informants experienced a loss of functional eating ability and the ability to perform activities related to food and meals. Feelings of dependence were experienced in mealtime situations.
  
  
  CONCLUSIONS
  Living with eating difficulties after stroke is a complex phenomenon. The informants felt abandoned because of lack of support from the nursing staff. They were left on their own to deal with the difficult process of adjusting to a new way of eating and losses regarding mealtime activities. The combination of repeated interviews and participant observations seemed to be an approach that should be tested in larger studies.
  
  
  CONCLUSIONS
  This case study indicates a need for nurses to develop and use evidence-based guidelines for eating training during the continuum of care. Nurses need to assess patient's habits and desires related to eating, and to adjust environment according to patient preferences.
authors.affiliation: Doctoral Student, Department of Caring Sciences, Orebro University, Orebro, Sweden. eva.carlsson@ivo.oru.se
authors.forename: Eva
authors.initials: E
authors.lastname: Carlsson
authors.forename: Anna
authors.initials: A
authors.lastname: Ehrenberg
authors.forename: Margareta
authors.initials: M
authors.lastname: Ehnfors
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000209:etiology* / Q000451:nursing / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications* / Q000451:nursing / Q000523:psychology