Experiencing the acute stroke unit: a hermeneutic phenomenological study from the perspective of stroke survivors and healthcare practitioners

Kitty Suddick, Vinette Cross, Pirjo Vuoskoski, Graham Stew

Research output: Contribution to conferenceAbstract


Background: Recently in the United Kingdom, traditional comprehensive stroke units were closed or reorganised into acute and hyperacute stroke units that emphasised assessment, medical management, and shorter lengths of stay.
Purpose: In response to this medical and technical drive, this study looked to reclaim the acute stroke unit as a human, lived through experience in all its’ meaningful qualitative character.
Method: Working with detailed interview accounts from four stroke survivors and four healthcare practitioners, this study drew on phenomenology and philosophical hermeneutics to uncover the experience of being on the acute stroke unit from a human lifeworld perspective.
Results: From the stroke survivors’ perspective the acute stroke unit emerged as a lived space in two meaningful but differentiated forms: holding space and transitional space. Holding was understood to provide distance, safety, protection, time and emotional support; was meaningfully related to need and existential vulnerability; was practiced by different people (including patients), and was not just the foreground, but could also be the impetus for transition. For the healthcare practitioners, the acute stroke unit was a dynamic, meaningful lived space where they experienced authenticity and belonging. It was also where they navigated the challenges and vulnerabilities they experienced in relation to their meaningful work; surviving and thriving in the space of the acute stroke unit.
Conclusion: This study highlights the meaningful holding and transitional contribution of the space of the acute stroke unit, and that patients as well as healthcare practitioners, can practice as well as transition in this space. The findings indicate that transition for stroke survivors is more expansive than recovery orientated. These transitions can be absent, or in-process, protective, necessitous or potentially driven transitions, and that people can quickly and dynamically move between them. For the healthcare practitioners, the space of the stroke unit offered them a sense of belonging, where they felt they could be true to themselves and flourish and thrive. However, the findings also demonstrated the complexity and challenge involved when they also experienced a diminished sense of belonging and thriving. This study is the basis for a number of planned publications. These findings are shared with occupational therapy and physiotherapy students at the University of Brighton to consider the relevance of qualitative research, the acute stroke unit experience, as well as the complexities of practice. Future work will also encompass using the maps within a knowledge exchange programme with clinical settings.
Implications: The importance of holding and transition needs more acknowledgement in services and organisations. Attunement to the individual, and particular ways patients hold each other and transition, will ensure that healthcare practitioners can be more sensitive and attentive to particular needs and responses at times of vulnerability and change. The findings indicate that transition, rather than change should be the emphasis when working with human beings experiencing adversity. It also supports the significance of lived spaces, their intertwined and complex nature, and the challenges that people experience as they navigate a path within and through them.
Keywords: phenomenology, acute stroke unit, lived space
Funding Acknowledgements: This study was undertaken with support of a small research grant provided by the Clinical Research Centre.
Ethics Approval: University of Brighton’s Faculty of Health and Social Science Faculty Research Ethics and Governance Committee, and National Research Ethics Committee.
Original languageEnglish
Publication statusPublished - 2019
EventSchool of Health Sciences Research and Enterprise Day - University of brighton, Darley Road, Eastbourne, United Kingdom
Duration: 3 Apr 20193 Apr 2019


ConferenceSchool of Health Sciences Research and Enterprise Day
Country/TerritoryUnited Kingdom


  • phenomenology
  • lived space
  • acute stroke unit


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