Weight gain after a stroke : the issue and control

Background - Over 900,000 people in England live with the effects of a stroke (NICE 2010). Modification of health behaviour can be crucial in stroke rehabilitation and in preventing avoidable long term impairment. Consultation with stakeholders identified a growing number of patients who are gaining weight as a longer term consequence following a stroke.

Aims - This study aims to i) explore the issues of weight gain for stroke survivors (aged less than 70); ii) identify what factors contribute to weight gain and iii) inform and develop patient pathways and services. This paper presents emerging findings.

Methods - A mixed method design using: surveys of South Yorkshire Cohort participants (n=87); interviews with staff (n=16); and framework analysis methods. Data collected June 2013-October 2013

Results - The long-term effects of strokes influencing weight gain are complex impacting on eating and activity behaviours and social isolation. Families, social networks and lifestyles before and after a stroke influence weight. Interviews indicated that timing of health promotion advice needs to take a patient centred approach and that people were challenged in controlling lifestyle and diet change following their stroke.

Discussion - The pathway of community based support is predominantly restricted to twelve weeks which impacts the quality and acceptability of advice given to patients and carers. The loss of control of lifestyle and diet in the medium to long-term was an overarching theme. This paper reflects on the findings and how nurses in acute and community settings can assess and facilitate patients in preventing and reducing weight gain in patients following stroke.

Conclusion - Care and information provided to stroke patients is restricted by pathways, availability of specialist support and current funding cuts to community based services. Long term follow up support would provide additional opportunities to influence the diets of patients and carers to reduce weight gain and risk factors for future chronic conditions.