A qualitative exploration of self-reported unmet need one year after stroke

Purpose: Stroke survivors consistently report longer-term problems after stroke, suggesting their needs are not being met. We developed a questionnaire to identify stroke survivor unmet needs. Preliminary questionnaire testing showed that despite residual impairment, nearly one third of respondents reported no/low unmet need. This qualitative study aims to gain insight into why stroke survivors report low/no unmet needs. Method: People who self-reported zero or one unmet need were purposively sampled, and semi-structured interviews conducted with ten participants. Identification and management of current problems was discussed,and thematic analysis undertaken. Results: Participants did not report having unmet need. Despite this, all participants identified current issues or problems. Living with problems while reporting no/low unmet need is explained through: acceptance of changed circumstances; making comparisons with other people and circumstances; valuing pride, determination or independence; viewing issues in the context of their expectations and experiences of services. Additionally, all participants were receiving some support. Conclusions: Self-identification of unmet needs is complex. Further investigation could explore the factors which enable stroke survivors to appropriately identify and experience no unmet needs, and whether these could be applied to reduce unmet needs of others.