Living in New World: A Qualitative Meta-Synthesis of Older Men’s Experience after Stroke

Main Article Content

Pulawit Thongtaeng
Junjira Seesawang


               Older men are more likely to have a stroke that can negatively affect their life. The purpose of this meta-synthesis was to bring together knowledge from qualitative studies focused on the experiences of older men following a stroke to form a new interpretation of this research field. Eligible studies published in English from January 2010 to December 2019 were identified from Medline, CINAHL, and PsycINFO. The main keywords were: stroke, male patient, older males, men with stroke, and qualitative research. Themes were identified through inductive and interpretative technique from each study and independently reviewed by another reviewer. This review included seven qualitative studies.
                 The literature described older men’s experiences following a stroke in five themes: (1) living in a different world, (2) breaking down of role fulfillment and relationships, (3) feeling down due to a difficult life, (4) embracing an uncertain future, and (5) adapting to the new world. The literature reviewed suggests that older men who have experienced a stroke face sudden and dramatic changes in their physical, emotional, and cognitive capabilities. Nevertheless, older men might undergo this transition more easily through the use of coping strategies and reconciliation of their self-identity. Stroke rehabilitation interventions related to concepts of masculinity need to be developed. Nurses should develop nursing interventions that including providing advice to older men about stroke strategies which help them to better cope with this life-changing event. The components of interventions need to be aligned with an individual’s experiences and the stroke’s impact on their life. Further studies need to explore how older men manage to overcome barriers to life adjustment after stroke.

Article Details

How to Cite
Thongtaeng P, Seesawang J. Living in New World: A Qualitative Meta-Synthesis of Older Men’s Experience after Stroke. PRIJNR [Internet]. 2021Jun.15 [cited 2021Oct.22];25(3):481-93. Available from:
Original paper


1. Almborg AH, Ulander K, Thulin A, Berg S. Discharged after stroke–important factors for health-related quality of life. J Clin Nurs. 2010;19(15-16):2196–206.

2. Koton P, Rexrode KM. Trends in stroke incidence in the United States. Will women overtake men? Neurology. 2017;89(10):982-3. doi: 10.1212/WNL.000000 0000004342.

3. Venketasubramanian N, Yoon BW, Pandian J, Navarro JC. Stroke epidemiology in South, East, and South-East Asia: a review. J Stroke. 2017;19(3):286-94. doi: 10. 5853/jos.2017.00234.

4. Katan M, Luft A. Global burden of stroke. Semin Neurol. 2018;38(2):208-11.doi: 10.1055/s-0038-1649503.

5. Haley WE, Roth DL, Hovater M, Clay OJ. Long-term impact of stroke on family caregiver well-being. Neurology. 2015;84(13):1323-9.doi: 10.1212/WNL.00000000 00001418.

6. Bucki B, Spitz E, Baumann M. Emotional and social repercussions of stroke on patient-family caregiver dyads: analysis of diverging attitudes and profiles of the differing dyads. PLoS ONE. 2019;14(4):e0215425.doi: 10. 1371/journal.pone.0215425.

7. Lincoln NB, Brinkmann N, Cunningham S, Dejaeger E, De Weerdt W, Jenni W, et al. Anxiety and depression after stroke: a 5 year follow up. Disabil Rehabil. 2013;35(2): 140-5.

8. Williams S, Murray C. The lived experience of older adults’ occupational adaptation following a stroke. Aust Occup Ther J. 2013;60(1):39-47.

9. Gillespie D, Campbell F. Effect of stroke on family carers and family relationship. Nurs Stand. 2011;26(2):39-46. doi: 10.7748/ns2011.

10. Kvigne K, Kirkevold M, Martinsen R, Bronken BA. Masculinity and strokes: the challenges presented to younger men by chronic illness. J Gend Stud. 2014;23(2): 197-210.doi: 10.1080/09589236.2013.790797.

11. Horne J, Lincoln NB, Preston J, Logan P. (2014). What does confidence mean to people who have had a stroke?-a qualitative interview study. Clin Rehabil. 2014;28(11): 1125-35.doi:10.1177/0269215514534086.

12. Salter K, Hellings C, Foley N, Teasell R. The experience of living with stroke: a qualitative meta-synthesis. J Rehabil Med. 2008;40:595-602.doi: 10.2340/16501977-0238.

13. Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. New York: Springer Publishing Company; 2007.

14. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. doi: 10.1371/journal.pmed.1000097.

15. Dalvandi A, Heikkila K, Maddah SSB, Khankeh HR, Ekman SL. Life experiences after stroke among Iranian stroke survivors. Int Nurs Rev. 2010; 57(2):247-53.

16. Medina DMV, Haltiwanger EP, Funk KP. The experience of chronically ill elderly Mexican-American men spouses as caregivers. Phys Occup Ther Geriatr. 2011; 29(3): 189-201.

17. Price P, Kinghorn J, Patrick R, Cardell B. “still there is beauty”: one man’s resilient adaptation to stroke. Scand J Occup Ther. 2012;19(2):111-7. doi: 10.3109/11038128. 2010.519402.

18. Anderson S, Whitfield K. Social identity and stroke: ‘they don’t make me feel like, there’s something wrong with me.’ Scand J Caring sci. 2012; 27(4):820-30.

19. de Guzman AB, Tan ELC, Tan EFS, Tan JRL, Tan TMC, Tanciano DMM, et al. Self-concept, disposition, and resilience of post stroke Filipino elderly with residual paralysis. Educ Gerontol. 2012;38(6):429-42. doi: 10.1080/03601277.2011.559861.

20. Williams S, Murray C. The lived experience of older adults’ occupational adaptation following a stroke. Aust Occup The J. 2013;60(1):39-47.

21. White JH, Patterson K, Jordan L, Magin P, Attia J, Strump JW. The experience of urinary incontinence in stroke survivors: a follow-up qualitative study. Can J Occup Ther. 2014; 81(2):124-34.

22. Critical Appraisal Skills Programme (CASP). 10 questions developed by the National CASP Collaboration for qualitative methodologies. [cited 2020 Jun 5]. Available from:

23. Sandelowski M, Barroso J. Classifying the findings in qualitative studies. Qual Health Res. 2003;13(7):905–23.

24. Kouwenhoven SE, Kirkevold M, Engedal K, Biong S. Kim HS. The lived experience of stroke survivors with early depressive symptom: a longitudinal perspective. Int J Qual Stud Health Well-being. 2011;6(4):1-13. doi: 10. 3402/qhw.v6i4.8491.

25. Nars N, Mawson S, Wright P, Parker J, Mountain G. Exploring the experiences of living with stroke through narrative: stroke survivors’ perspectives. Glob Qual Nurs Res. 2016;3:1-9. doi: 10.1177/2333393616646518.

26. Golics CJ, Basra MKA, Salek MS, Finlay AY. The impact of patients’ chronic disease on family quality of life: an experience from 26 specialties. Int J Gen Med. 2013; 6:787-98. doi: 10.2147/IJGM.S45156.

27. Verschuren JE, Enzlin P, Dijkstra PU, Geertzen JH, Dekker R. Chronic disease and sexuality: a generic conceptual framework. J Sex Res. 2010;47(2):153–70. doi: 10.1080/00224491003658227.

28. Carrillo-González GM, Sánchez-Herrera B, Chaparro-Diaz L. Chronic disease and sexuality. Invest Educ Enferm. 2013;13(2):295–304.

29. Asadi E, Mansour L, Khodabakhshi A, Fathabadi J. The relationship between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with diabetic husbands and comparing them with women with non diabetic husbands. J Fam Res. 2013;9(35):311–24.

30. Bucki B, Spitz E, Baumann M. Emotional and social repercussions of stroke on patient-family dyads: analysis of diverging attitudes and profiles of the differing dyads. PLoS ONE. 2019;14(4):e0215425. doi: 10.1371/ journal.pone.0215425.

31. Buono VL, Corallo F, Bramanti P, Marino S. Coping strategies and health-related quality of life after stroke. J Health Psychol. 2017;22(1):16-28. doi: 10.1177/1359105315595117.

32. Goodwin BC, Ralph N, Ireland MJ, Hyde MK, Oliffe JL, Dunn J, et al. The role of masculinities in psychological and emotional help-seeking by men with prostate cancer. Psychooncology. 2020;29(2):356-63. doi: 10.1002/ pon.5264.

33. Occhipinti S, Laurie K, Hyde MK, Martin S, Oliffe J, Wittert G, et al. Measuring masculinity in men with chronic disease. Am J Mens Health. 2019;13(4):1-7. doi:10.1177/ 1557988319859706.