title: Exploring poststroke mood changes in community-dwelling stroke survivors: a qualitative study.
abstract: OBJECTIVE
  To explore the long-term experience of mood changes in community-dwelling stroke survivors at 1, 3, and 5 years after stroke.
  
  
  METHODS
  A qualitative study using a modified grounded theory approach. The primary data collection method was semi-structured interviewing.
  
  
  METHODS
  Community-dwelling stroke survivors in metropolitan Newcastle, NSW, Australia.
  
  
  METHODS
  Twelve community-dwelling stroke survivors (6 men, 6 women; age range 43-92y; 4 participants from each cohort) discharged from a tertiary referral hospital.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Qualitative outcomes were participants' perceptions using in-depth, semi-structured interviews with participants from 3 community-based cohorts of stroke survivors at 1, 3, and 5 years poststroke.
  
  
  RESULTS
  Four main categories of mood change were described by participants including feelings of frustration, reduced self-efficacy, dependency, and loss. Factors that modulated these mood changes included the presence or absence of insight, hope for the future, faith, and support. A modified grounded theory approach was used for data analysis using a process of constant comparison.
  
  
  CONCLUSIONS
  Mood changes continued well beyond discharge and in some cases commenced after discharge in this sample of stroke survivors. Use of qualitative methodology extends our understanding of the extent and nature of low mood after stroke. There is a need for enhanced services to monitor and address low mood.
authors.affiliation: Hunter Stroke Service, Hunter New England Area Health Service, New South Wales, Australia. jennifer.white@hnehealth.nsw.gov.au
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: White
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Michael R
authors.initials: MR
authors.lastname: Pollack
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sturm
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Levi