Background and objectives: Stroke has been described as disruptive and traumatic, something exacerbated for those with communication impairments because of the central role of communication in engagement, relationships, identity, and sense-making. Our research, examining communication accessibility in Aotearoa, explores how the loss of communication and connection exacerbates the traumatic nature of stroke.
Methods: Using Interpretive Description, 8 Māori and 15 tauiwi (non-Māori) with post-stroke communication issues and 13 healthcare professionals participated in individual and whānau (family)-based interviews. Māori analysis followed kaupapa Māori theory, while tauiwi analysis applied conventional content analysis.
Results: Stroke, and stroke care, commonly left people without connections and control. Initially, many appreciated healthcare teams taking control to ensure survival. However, as people became aware of the broader impacts of stroke, they required time, connection, and personal empowerment, things achieved through communication and relationships. Communication impairments intensified disconnection and trauma responses, linked to disconnection from self and whānau, limited communication and connection with healthcare staff, dehumanised care, and insufficient communication support for understanding, contribution, and decision-making. For Māori, disconnection reinforced longstanding whānau experiences of trauma in western healthcare systems shaped by colonisation.
Conclusion: Our research shows how every interaction has therapeutic potential to support connections and reconstruction of identity. Further, they can create relational environments that are further traumatising or healing. Conceptualising stroke, and communication impairment, as a traumatic event requires healthcare professionals to explicitly work to foster connection and communication, and to empower people to have autonomy in their healthcare journey.