Psychosocial well-being after stroke in Aotearoa New Zealand: a qualitative metasynthesis.

Psychosocial well-being is key to living well after stroke, but often significantly affected by stroke. Existing understandings consider well-being comes from positive mood, social relationships, self-identity and engagement in meaningful activities. However, these understandings are socioculturally located and not necessarily universally applicable. This qualitative metasynthesis examined how people experience well-being after a stroke in Aotearoa New Zealand. This metasynthesis was underpinned by He Awa Whiria (Braided Rivers), a model which prompts researchers to uniquely engage with Māori and non-Māori knowledges. A systematic search identified 18 articles exploring experiences of people with stroke in Aotearoa. Articles were analysed using reflexive thematic analysis. We constructed three themes which reflect experiences of well-being: connection within a constellation of relationships, being grounded in one's enduring and evolving identities, and being at-home in the present whilst (re)visioning the future. Well-being is multi-faceted. In Aotearoa, it is inherently collective while also deeply personal. Well-being is collectively achieved through connections with self, others, community and culture, and embedded within personal and collective temporal worlds. These rich understandings of well-being can open up different considerations of how well-being is supported by and within stroke services. Psychosocial well-being is critical for people living with stroke. Well-being should be a priority in rehabilitation, however people with stroke indicate they do no consistently receive psychosocial support. It is clear that well-being has strong cultural elements, and understanding what supports well-being in individuals, whānau (those within wider networks who the person with stroke considers important), and wider cultural groups is important. Supporting whānau is crucial as whānau are core to well-being both during and beyond rehabilitation, and their own well-being is impacted by stroke. [ABSTRACT FROM AUTHOR]