title: Circumstances surrounding the onset of stroke: a qualitative study.
abstract: OBJECTIVE
  To document perceptions of circumstances spontaneously associated with the occurrence of the stroke on that particular day.
  
  
  BACKGROUND
  Known triggers of stroke include birthday or negative emotions. However, specific circumstances relating to that birthday or emotion have not yet been documented.
  
  
  METHODS
  Phenomenological perspective where data were collected between October 2011-June 2012.
  
  
  METHODS
  In-depth interviews conducted 5-8 weeks post stroke with 37 participants, with a mean age of 56·3 years (sd 11·9) and 40·5% (14/37) of whom were female. An interview guide composed of open-ended questions and developed with experts was used to explore in detail free associations surrounding the stroke. All interviews were audiotaped and transcribed. Data were rigorously analysed by two team members and discussed in team meetings until reaching consensus on essential themes.
  
  
  RESULTS
  Relationships emerged as being the overarching theme related to stroke triggers with the interrelated subthemes of: (1) birthday or anniversary; (2) parenting; (3) being sick seen as a benefit; and (4) alcohol or drug abuse. The stroke happened on a day which was related in some way to a relationship with a significant other affected by tension, a lack of transparency or an overinvestment of emotional/affective state.
  
  
  CONCLUSIONS
  There is a need to address individuals' beliefs as a part of secondary prevention interventions to be truly client-centred, which the phenomenological perspective allows. Relationships as a potential source of stress should be added as a theme to discuss with patients for a holistic approach to stroke prevention including psychosocial factors.
authors.affiliation: Montreal University, Quebec, Canada.|Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Rochette
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaulin
authors.affiliation: Montreal University, Quebec, Canada.|Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada.
authors.forename: Laury
authors.initials: L
authors.lastname: Chamelian
authors.affiliation: Montreal University, Quebec, Canada.|Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Hebert
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada.
authors.forename: Marlene
authors.initials: M
authors.lastname: Lapierre
authors.affiliation: Montreal University, Quebec, Canada.|Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada.
authors.forename: Yan
authors.initials: Y
authors.lastname: Deschaintre
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D018570:Risk Assessment; D013315:Stress, Psychological / Q000150:complications*; D020521:Stroke / Q000209:etiology* / Q000523:psychology*
keywords: nursing; phenomenology; prevention; relationships; stress; stroke; trigger