Body image and Self-esteem Dynamics in the Context of Performing Self-care Activities among People with Stroke: A Qualitative Study

Abstract

Background: Stroke ranks third globally in terms of both death and disability, and it is the second most common cause of death worldwide. Stroke is a leading cause of death in Asia, accounting for about two-thirds of all stroke-related deaths globally. In Bangladesh, cerebrovascular disease ranks third. After enduring a stroke, most people become dependent on others in some way, which affects their day-to-day lives; adapting to this new reality takes time and effort that can significantly impact their body image. These changes may lead to negative feelings about their appearance, resulting in low self-esteem, diminished quality of life and even mental health challenges like depression. Aim: The aim of this study was to explore the interrelation between body image perception, self-esteem, and their influence on performing self-care activities among stroke survivors. Methods: This study followed a qualitative study using narrative enquiry approach. A semi-structured in depth interviews were conducted in a sample of 13 stroke survivors including eight women and five men. In order to get this specific number of participants, the data saturation process was used. Data were analyzed following thematic analysis. The study was conducted at the Centre for the Rehabilitation of the Paralysed (CRP), specifically within the outpatient unit focused on adult neurology. Result: The study highlighted the challenges that people with stroke face in relation to their body image and self-esteem while performing self-care activities. The perceptions regarding bodily changes in people with stroke emerged of six themes i) Perception of self, ii) Body image, iii) Psychological wellbeing, iv) Body image & Self-esteem in relation to perform self- care activities, v) Post stroke adjustment to body image & self- esteem, vi) Factors affecting self-care performance in relation to body image and self-esteem. The amount of time since the injury, family support and attitudes, and some others factors considered facilitators for coping with body changes after stroke. Conclusion: Experiencing a stroke suggests a shift in body awareness, self- perception, self-esteem and body image issues, which affects their capacity to engage in self-care. Healthcare providers have more positive attitudes and actively assist patients in adjusting to their new body schema when they are aware of the changes that occur in