Behind the Science: Stroke and health inequities in women

Interviewee: Ismália De Sousa, PhD Candidate, RN, University of British Columbia, School of Nursing, Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators).

Published: July 7th, 2023

Could you tell us more about your research?

My Ph.D. research is a two-phase project. The first part is a critical review of health inequities in stroke. The second phase is a qualitative study on the experience of young women with stroke history in British Columbia, with an equity-oriented lens. My research is at the intersection between stroke and health inequities, specifically for young women.

What drove you to study the experience of stroke in young women?

I’ve been a registered nurse for 14/15 years. In my career as a registered nurse, I specialized in stroke. For this reason, I have a clear understanding of stroke physiology, but also of the complexities of care that stroke survivors experience. In the last 20 years, the focus has been on the acute stroke phase (those immediate hours to days after the stroke) but not so much on the rehabilitation phase. I think there is a gap in stroke research. Another component is that people often think strokes occur predominantly in older people, but this is not true. A third of strokes can occur in younger people. Surprisingly, the numbers are increasing, and we have more young people having strokes. Moreover, there are sex differences in stroke outcomes. For example, females in specific age categories have been reported to have novel or multiple strokes compared to males. Then there is the health inequities part that needs consideration. It’s not just about knowing the data and the numbers but also about how people experience it. What does that mean for people that experience a stroke? What does that mean in terms of accessing stroke rehabilitation when it comes to inequities?

What impact do you hope to see with this work?

I really hope that my findings can influence health policy or can inform health policy and clinical practices and the development of equitable practices in stroke care in the world. I also think that there may be gaps in research, I think when we think about stroke research in Canada, there’s a big emphasis on the Heart and Stroke Foundation. They have strategic priorities and they really do focus on women and health inequity. I think this work needs to continue but not only in Canada. The World Health Organization (WHO) recently released a statement for countries to prioritize brain health. Since strokes are a neurological condition I could see this as a good opportunity for stroke research to continue on a global level.

Are there other projects you are currently working on?

Another project I worked on looks at the History of black nurses in British Columbia, between 1845 and 1910. This is important because we need to reflect on the invisibility, of blackness in British Columbia but also to be able to understand how some of our current-day issues stem from black erasure and events that have happened in the past. Specifically, the lack of representation of black nurses in leadership positions. This work is about what has happened in the past, and how it has a trickle-down effect on where we are today. The specific time that I looked at, which was a fundamental time for nursing, was the beginning of the professionalization of nursing. This was when nurses started to get trained within nursing schools. Many had believed that slavery was over but black people were continuously stereotyped as less intelligent, and lazy, which I think then had a huge impact on black nurses and this prevented black nurses from getting into nursing schools.

I’ve also recently done some work on looking at student nurses’ perceptions of educational strategies that promote critical awareness and engagement with social justice. In this setting, we talk about social justice within nursing and how to implement it as a professional mandate in classrooms. I interview students to understand how they see social justice and what educational strategies should be used or have been used that promote that critical awareness and engagement.

Where can people learn more about your work?

Find more about what I do on my website where you can see my publications and other projects I’m working on. Find Ismália on Twitter at @Ismalia_S.