This aim of this thesis was to explore experiences of emotional distress and sleep-wake
patterns in an acute stroke rehabilitation setting. Both the systematic review and research
paper are being prepared for submission to the international Journal of Stroke; the guidelines
of which are included in the appendices (Appendix D, paper 1).
Paper one is a systematic review of the literature investigating the potential benefit
of third-wave psychological therapies to support individuals experiencing emotional distress
resulting from previous stroke. Ten papers were reviewed and included in a narrative
synthesis. The quality of the methodology of the studies is evaluated and discussed. Third
wave interventions offer some promising initial results; however, research in this area is in
its infancy, and requires further investigation.
The research paper (paper two) explored the relationship between sleep, mood and
pain and the possible predictive value these variables have on participation in rehabilitation.
Experience sampling methods and actigraphy were utilised in this study. Twenty
participants were recruited and took part in the study for an average of seven days. A multi
level model analysis was used to explore the data. Results indicate that sleep efficiency, low
mood and pain all offer some predictive value for participation in rehabilitation in this
sample.
Paper three is a critical appraisal of the systematic review and research paper.
Pertinent issues, relevant to both papers are discussed. Recommendations for future
research as well as considerations for clinical implications are discussed within the context
of the research findings.