ISSUES AND INNOVATIONS IN NURSING PRACTICE Eating difficulties after stroke Lin Perry PhD RGN RNT Senior Research Fellow, Health Care Research Unit, St Bartholomew School of Nursing and Midwifery, London, UK and Susan McLaren BSc PhD RGN Professor of Nursing, Faculty of Health and Social Care Sciences, Kingston University/St George’s Hospital Medical School, Surrey, UK Submitted for publication 19 December 2002 Accepted for publication 19 May 2003 Correspondence: Lin Perry, Health Care Research Unit, St Bartholomew School of Nursing and Midwifery, City University, 20 Bartholomew Close, London EC1A 7QN, UK. E-mail: l.perry@city.ac.uk PERRY L. & M PERRY L. & Mc LAREN S. (2003) LAREN S. (2003) Journal of Advanced Nursing 43(4), 360–369 Eating difficulties after stroke Background. Stroke is a common and enduring problem, producing a wide range of effects that may impact on all aspects of life. One area that has seldom been investigated is the effects of stroke on ability to eat and, particularly, stroke survi- vors’ subjective experiences of eating-related difficulties. Aim. To investigate stroke survivors’ reports of eating-related experiences 6 months after stroke. Methods. Participants were 206 survivors of acute stroke who were admitted to hospital between March 1998 and April 1999. Those able to communicate and who gave informed consent participated in a semi-structured interview and assessment of eating abilities in their homes 6 months after their stroke. Interviews were tape recorded and transcribed and 113 interviews with eating disabled participants were entered onto QSR NUD*IST 4 for thematic analysis. Analyses were later checked independently. Findings. At 6 months, 34%, 61% and 5% had no, slight and moderate eating disablements, respectively. A range and variety of difficulties were discussed, but relationships between degrees of disablement and handicap were not straightfor- ward; effects seemed more closely related to participants’ responses than objective difficulties. Eating and related activities were clearly important aspects of life for these stroke survivors, socially and psychologically, as well as functionally. Pre- stroke activities were sometimes maintained, with considerable effort. Conclusions. Findings indicated issues of relevance for those involved with early rehabilitation interventions and highlighted aspects of continuing care service delivery that warrant review. The relative lack of attention paid to eating-related aspects of care is an important oversight. Keywords: stroke, nursing, eating disability, dysphagia, users’ views, qualitative study Introduction Stroke is a common problem, with an estimated overall incidence of first-in-a-lifetime stroke of 2®4 per 1000 population per year but, including all acute strokes, the figures may be 20–30% higher (Wolfe 1996). Stroke produces a wide variety of physical, cognitive, emotional and social effects that may persist long beyond the acute phase or hospitalization. The first 3 months after stroke have been described as a phase of early rapid recovery. Individuals retain ability to respond to therapy later, but major gains have been accomplished before 6 months, 360 Ó 2003 Blackwell Publishing Ltd