Using "Own-Point-of-View" Video and Stimulated Recall to Reveal Physician Thought Processes: A Methodology Paper.

Stroke, experienced by approximately 9000 people each year in Aotearoa New Zealand (referred to hereinafter as Aotearoa) [], can have a range of impacts on a person's life. One area that has been identified as worthy of attention is the area of well‐being []. People with stroke report that well‐being is not consistently addressed in stroke services and remains an area of unmet need [, ]. Health professionals agree. Many acknowledge the importance of supporting well‐being, but describe feeling constrained in their ability to do so []. Well‐being is multifaceted, dynamic and varied across contexts []. What constitutes well‐being is unique to each individual, influenced by personal traits, social circumstances and worldview []. As such, providing a succinct definition that captures the essence of well‐being is challenging. Instead, it may be better understood through its key characteristics []. In previous work, we have argued that while well‐being is unique to each person and their family, key elements consistently arise. It is deeply relational, grounded in connections with others, and incorporating a sense of self and identity, finding balance in the present and holding hope for the future []. Well‐being is culturally grounded, with Māori, the indigenous peoples of Aotearoa, highlighting the importance of deep connections to people and places of meaning, and to one's cultural identity. Wairua (spiritual sense), upholding of mana (inherent standing) and rangatiratanga (autonomy and sovereignty) were also described as core elements of well‐being for many Māori []. Such elements can be disrupted by stroke, for example through a loss of connection to self‐identity, to meaningful roles, activities, cultural practices, people and places [, ]. People are often grappling with challenges to their well‐being whilst receiving care from stroke services and, as such, there is opportunity, and need, for health professionals and stroke services to support well‐being in this time [, , ]. This study forms part of a larger research project that sought to understand what is important for well‐being after stroke and to improve how it is addressed in stroke services. One notion that consistently came through the interviews with people impacted by stroke was the depth of work that they were doing to support their well‐being, often from very early post‐stroke. Such work appeared largely unseen in the context of stroke services. We draw on Corbin and Strauss’ concept of ‘work’, which encompasses the tasks undertaken by an individual or group, how and where those tasks are performed, and the consequences, challenges and problems associated with carrying them out. While ‘work’ is often associated with physical activities, this sociological concept has been used to explore how people manage the impacts of illness on their sense of self through a form of work called biographical work [], and to understand how people manage the burden of healthcare following stroke or chronic illness, recognising this treatment burden is a form of work []. However, there has been limited exploration of the work that people do to support their well‐being more broadly following stroke. Several authors have highlighted the challenging nature of life early post‐stroke—a time when support from stroke services is typically most intensive. People are commonly coping with shock, making sense of their new reality, adjusting to changed abilities and navigating altered perceptions of their capacity and self‐identity [, , , ]—all activities which indicate forms of work that are undertaken to support well‐being. Our research examines this further, seeking to develop deeper understandings of the work that people do while under the care of stroke services, to make such work more visible and provide opportunities for it to be recognised and supported. As such, the aims of this present study are to identify the work undertaken by people impacted by stroke to maintain and enhance their well‐being whilst receiving care from stroke services, and to examine how stroke services appeared to influence this work. This qualitative study was underpinned by Interpretive Description [], a methodology which explores and interprets phenomena while remaining situated within the practice context.