Micaela Rodrigues¹, Inês dos Santos Silva² and Luísa Soares¹

¹Universidade da Madeira, Portugal
²2256c Health, Ltd., Portugal

*Corresponding Author: Luísa Soares, Universidade da Madeira, Portugal.

Received: May 23, 2025; Published: May 28, 2025

Abstract

Stroke remains one of the leading causes of death globally and one of the primary sources of long-term disability. Beyond the direct impact on physical health, its consequences often extend to survivors' and their caregivers' psychological, emotional, and social wellbeing. Loss of autonomy, cognitive and emotional changes, and disruptions in interpersonal routines demand complex and ongoing adaptation. In this context, social support plays a crucial role—not only as a complement to formal healthcare but also as a protective factor that promotes rehabilitation, facilitates emotional adjustment and significantly enhances the quality of life. The main objective of this case study was to understand how therapeutic writing (narratives), mediated via WhatsApp, promotes social support in groups of stroke survivors through the sharing of messages within a therapeutic group. Results showed that participation in a WhatsApp group helped to improve emotional support, a sense of belonging, and the construction of a renewed sense of life in the post-stroke period. The group's narratives revealed strong emotional engagement and moments of introspection, with writing and sharing as valuable therapeutic tools that fostered wellbeing, resilience, and peer connection. These findings confirm the potential of hybrid intervention models using WhatsApp to promote group cohesion, emotional regulation, and psychosocial support in recovery and rehabilitation contexts for stroke survivors.

Keywords: Therapeutic Groups; Therapeutic Writing; Mobile Applications; Social Support

References

1. Ablewhite J., et al. “How do stroke survivors and their caregivers manage post-stroke fatigue? A qualitative study”. Clinical Rehabilitation10 (2022): 1400-1410.
2. Alazzawie A. “The Linguistic and Situational features of WhatsApp Messages”. Advance (2020).
3. Ayaz M., et al. “Enhancing Knowledge of Family Caregivers and Quality of Life of Patients with Ischemic Stroke”. Pakistan Journal of Neurological Surgery 4 (2022): 558-568.
4. Azios JH., et al. “Friendship matters: A research agenda for aphasia”. Aphasiology 3 (2021): 1-20.
5. Baker C., et al. “It was really dark”: the experiences and preferences of people with aphasia to manage mood changes and depression”. Aphasiology1 (2019): 1-28.
6. Batista J., et al. “Write and Let Go: An Online Writing Program for University Students”. Frontiers in Psychology 13 (2022): 874600.
7. Benetti I., et al. “O poder terapêutico da escrita: quando o silêncio fala alto”. Brazilian Journal of Mental Health19 (2016): 67-76.
8. Bermudo-Gallaguet A., et al. “Understanding and enhancing post-stroke recovery: Insights from a nested qualitative study within the MindFit Project randomized clinical trial”. Complementary Therapies in Medicine 87 (2024): 103100.
9. Boulos K., et al. “Instagram and WhatsApp in Health and Healthcare: An Overview”. Future Internet3 (2016): 37.
10. Chow Oi-Wah Esther. “Responding to lives after stroke: Stroke survivors and caregivers going on narrative journeys”. The International Journal of Narrative Therapy and Community Work 4 (2022): 38.
11. Chow E O., et al. “Actor-partner effects of wellbeing, hope and self-esteem on depression in stroke survivor-caregiver dyads: A randomized controlled trial”. Clinical Rehabilitation3 (2023): 394-406.
12. Direção Regional de Estatística da Madeira. “Óbitos por local de residência, sexo e causa de morte .Lista Sucinta Europeia segundo o grupo etário - 2022 Ficheiro Excel”. Portal de Estatísticas Oficiais (2025).
13. Erler KS., et al. “Social Support as a Predictor of Community Participation After Stroke”. Frontiers in Neurology 10 (2019).
14. Fama ME., et al. “The Impact of the COVID-19 Public Health Crisis on Communication and Quality of Life: Insights From a Community of Stroke and Brain Trauma Survivors”. American Journal of Speech-Language Pathology4 (2021): 1805-1818.
15. Figueiras M., et al. “Escrita terapêutica em contextos de saúde: Uma breve revisão”. Análise Psicológica,26 (2008): 327-334.
16. Garg D., et al. “Use of Social Media in Stroke: A Systematic Review”. Annals of Indian Academy of Neurology3 (2023): 206-212.
17. Giordano V., et al. “WhatsApp Messenger as an Adjunctive Tool for Telemedicine: An Overview”. Interactive Journal of Medical Research2 (2017).
18. Gonçalves ÓF., et al. “Analyzing structure, process and content in narratives of patients diagnosed with agoraphobia”. International Journal of Clinical and Health Psychology 2 (2002a): 389-406.
19. Gonçalves OF., et al. “Manual de Avaliação da Estrutura e Coerência Narrativa”. Departamento de Psicologia, Universidade do Minho (2001a).
20. Gonçalves OF., et al. “Manual de Avaliação do Processo e Complexidade Narrativa”. Departamento de Psicologia, Universidade do Minho (2001b).
21. Gonçalves O F., et al. “Manual de Avaliação do Conteúdo e Multiplicidade de Narrativa”. Departamento de Psicologia, Universidade do Minho.
22. Harrison M., et al. “Psychological and emotional needs, assessment, and support post-stroke: a multi-perspective qualitative study”. Topics in Stroke Rehabilitation2 (2017): 119-125.
23. Hartke R J., et al. “The Use of Writing Groups to Facilitate Adaptation After Stroke”. Topics in Stroke Rehabilitation1 (2007): 26-37.
24. Hazelwood A. “Using text messaging in the treatment of eating disorders”. Nursing Times 104 (2008): 28-29.
25. Instituto Nacional de Estatística. Causas de Morte 2022 (2024).
26. Kaufmann K and Peil C. “The mobile instant messaging interview (MIMI): Using WhatsApp to enhance self-reporting and explore media usage in situ”. Mobile Media and Communication 2 (2020): 229-246.
27. Kingau NW., et al. “The impact of stroke support groups on stroke patients and their caregivers”. Rehabilitation and Developing Health Systems 1 (2024): a9.
28. Kristensen HK., et al. “The Importance of Patient Involvement in Stroke Rehabilitation”. PLOS ONE 6 (20162): e0157149.
29. Lamont RA., et al. “Shared social identity and perceived social support among stroke groups during the COVID‐19 pandemic: Relationship with psychosocial health”. Applied Psychology: Health and Well-Being1 (2022).
30. Leal T and Soares L. “Therapeutic writing in Palliative Care: a systematic review - A death free of tubes with narrative communication skills”. Journal of Poetry Therapy (2024): 1-20.
31. Lee Teh P., et al. “Sentiment analysis tools should take account of the number of exclamation marks!!!”.
32. Mahmood A., et al. “Development of strategies to support home based exercise adherence after stroke: a Delphi consensus”. BMJ Open1 (2022): e055946.
33. Marshall J., et al. “Evaluating the Benefits of Aphasia Intervention Delivered in Virtual Reality: Results of a Quasi-Randomised Study”. PLOS ONE8 (2016): e0160381.
34. Massaro A R and Battistella L R. “Stroke patients and their caregivers: an interdependent relationship crucial for stroke care. Pacientes com acidente vascular cerebral e seus cuidadores: uma relação de interdependência para o atendimento pós-hospitalar”. Arquivos de neuro-psiquiatria3 (2024): 1-2.
35. Minayo M C de S. “Análise qualitativa: teoria, passos e fidedignidade”. Ciência and Saúde Coletiva3 (2012): 621-626.
36. Mukherjee D., et al. “The Cognitive, Emotional, and Social Sequelae of Stroke: Psychological and Ethical Concerns in Post-Stroke Adaptation”. Topics in Stroke Rehabilitation4 (2006): 26-35.
37. Nasir K G and Al-Ghizzy MJD. “Linguistic features of netspeak: Abbreviations, acronyms and punctuation marks”. University of Thi-Qar Journal of education for Humanities Science1 (2019): 1-69.
38. Opara J A and Jaracz K. “Quality of life of post-stroke patients and their caregivers”. Journal of medicine and Life3 (2010): 216-220.
39. Paiva T C., et al. “Therapeutic writing and the grieving process of mothers who experienced early pregnancy loss - narrative well-being”. Journal of Poetry Therapy (2024): 1-27.
40. Pennebaker J. “Theories, therapies, and taxpayers: On the complexities of the expressive writing paradigm”. Clinical Psychology: Science and Practice2 (2004): 138-142.
41. Pennebaker J W and Graybeal A. “Patterns of natural language use: Disclosure, personality, and social integration”. Current Directions in Psychological Science 10 (2001): 90-93.
42. Pennebaker J and Seagal, J. “Forming a story: The health benefits of narrative”. Journal of Clinical Psychology 10 (1999): 1243-1254.
43. Reid D and Reid F. “The expressive and conversational affordances of mobile messaging”. Behaviour and Information Technology 29 (2007): 3-22.
44. Roitman Y and Yeshua-Katz D. “WhatsApp group as a shared resource for coping with political violence: The case of mothers living in an ongoing conflict area”. Mobile Media and Communication1 (2021): 3-20.
45. Santos P and Soare L. “Narrative Therapy in Complicated Grief: A Systematic Literature Review”. Journal of Chemical Research 3 (2024): 1-12.
46. Silva I S., et al. “The Role of Technology in Enhancing Emotional Wellbeing in Recovery: Integrating WhatsApp for Mutual Support Among Care Communities: A Case of Stroke Survivors”. ATSK Journal of Psychology 2 (2024).
47. Silva I S., et al. “Investigating Social Sensemaking Technologies for Emotional Wellbeing of Stroke Survivors and Caregivers”. Proceedings of the ACM on Human-Computer Interaction2(2025):1-28.
48. Silva I S., et al. “Investigating the opportunities for technologies to enhance QoL with stroke survivors and their families”. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems (2020): 1-11.
49. Soares L., et al. “Clinical Psychology and the New Technological Challenges After Covid-19”. Novel Practices in Med Study2 (2023): NPMS.000510.2023.
50. Syahfitri R D., et al. “Emoji in WhatsApp Group Conversation”. Advances in Social Science, Education and Humanities Research (2021): 591.
51. Völker J and Mannheim C. “Tuned in on senders’ self-revelation: Emojis and emotional intelligence influence interpretation of WhatsApp messages”. Computers in Human Behavior Reports 3 (2021): 100062.
52. Walsh M E., et al. “Factors associated with community reintegration in the first year after stroke: a qualitative meta-synthesis”. Disability and Rehabilitation 37 (2015): 1599-1608.
53. “Therapeutic texting Understanding text messaging as an e-therapy”. Youthline Digital Health Promotion Strategy. Auckland: Youthline (2010).
54. Zhang W., et al. “Trajectory and predictors of family function in caregivers of stroke survivors: A longitudinal study of the first 6 months after stroke”. Journal of Advanced Nursing1 (2023): 264-274.

Citation

Citation: Luísa Soares., et al. “Supportive Conversations: WhatsApp as a Tool for Social Support Among Women Stroke Survivors – A Case Study". Acta Scientific Women's Health 7.6 (2025): 72-84.

Copyright

Copyright: © 2025 Luísa Soares., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.