Flourishing as a concept to understand stroke recovery: Findings from a community-based interview study

Background. Positive psychology concepts related to human flourishing, including hope and optimism are receiving increasing attention in a range of non-clinical populations and settings. This study explores the utility of human flourishing in the understanding of stroke recovery.

Aim. To examine whether the concept of ‘flourishing’ can be meaningfully applied to stroke recovery

Method. We conducted semi-structured interviews with 34 (Mdn age 66 years, min 32, max 81; 55.9% male) community-dwelling people after stroke. Thematic framework analysis was guided by Seligman’s concept of PERMA that summarises evidenced key components of human flourishing.

Results. While all PERMA constructs could be identified, their content was bound up in the recovery process. Hope was a strong, recurrent theme but some also expressed negative feelings about lost activities. Some found positive flow experiences through active engagement in the rehabilitation process compensating for lost activity areas. Family relationships and friendships were highly valued by participants. Some, however, felt at times ‘overprotected’, which strained relationships. Stroke recovery was associated by many with a journey that made them reflect about meaning and purpose of their lives and some saw the attainment of key rehabilitation goals (e.g. driving, retuning to leisure pursuits, working) as moving them on. No differences were found between groups of different impairment severity (including people with aphasia).

Discussion.  Rehabilitation is mostly based on a functional deficit model. Flourishing relates to important life roles and participation areas and appears to be of importance in the recovery process and thus should be supported by professionals.