Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Lloyd, Anna; Bannigan, Katrina; Sugavanam, Thavapriya; Freeman, Jennifer

doi:10.11124/jbisrir-2017-003499

Cited by 52 publications

(109 citation statements)

References 34 publications

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“…To maximise the effectiveness of self-management programs, effort must be made to set well-defined recovery goals and ensure goals are person-centred (and not clinician imposed) [ 9 ]. Having ongoing support to achieve these goals is also key for goal attainment [ 10 , 11 ], but often there are barriers faced once people return to community living after discharge from the hospital.…”

Section: Introductionmentioning

confidence: 99%

Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: feasibility assessment in survivors 12–24 months post-event

Cadilhac

Andrew

Busingye

et al. 2020

Pilot Feasibility Stud

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Background Electronic communication is used in various populations to achieve health goals, but evidence in stroke is lacking. We pilot tested the feasibility and potential effectiveness of a novel personalised electronic self-management intervention to support person-centred goal attainment and secondary prevention after stroke. Methods A phase I, prospective, randomised controlled pilot trial (1:1 allocation) with assessor blinding, intention-to-treat analysis, and a process evaluation. Community-based survivors of stroke were recruited from participants in the Australian Stroke Clinical Registry (AuSCR) who had indicated their willingness to be contacted for research studies. Inclusion criteria include 1–2 years following hospital admission for stroke and living within 50 km of Monash University (Melbourne). Person-centred goals were set with facilitation by a clinician using a standardised template. The intervention group received electronic support messages aligned to their goals over 4 weeks. The control group received only 2–3 electronic administrative messages. Primary outcomes were study retention, goal attainment (assessed using Goal Attainment Scaling method) and satisfaction. Secondary outcomes were self-management (Health Education Impact Questionnaire: 8 domains), quality of life, mood and acceptability. Results Of 340 invitations sent from AuSCR, 73 responded, 68 were eligible and 57 (84%) completed the baseline assessment. At the goal-setting stage, 54/68 (79%) were randomised (median 16 months after stroke): 25 to intervention (median age 69 years; 40% female) and 29 to control (median age 68 years; 38% female). Forty-five (83%) participants completed the outcome follow-up assessment. At follow-up, goal attainment (mean GAS-T score ≥ 50) in the intervention group was achieved for goals related to function, participation and environment (control: environment only). Most intervention participants provided positive feedback and reported that the iVERVE messages were easy to understand (92%) and assisted them in achieving their goals (77%). We found preliminary evidence of non-significant improvements between the groups for most self-management domains (e.g. social integration and support: β coefficient 0.34; 95% CI − 0.14 to 0.83) and several quality-of-life domains in favour of the intervention group. Conclusion These findings support the need for further randomised effectiveness trials of the iVERVE program to be tested in people with new stroke. Trial registration ANZCTR, ACTRN12618001519246. Registered on 11 September 2018—retrospectively registered.

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Section: Introductionmentioning

confidence: 99%

Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: feasibility assessment in survivors 12–24 months post-event

Cadilhac

Andrew

Busingye

et al. 2020

Pilot Feasibility Stud

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“…Also, based on the recommendation of the panel of experts, goal setting was included as one of the components of the assessment phase. Even though goal setting during stroke rehabilitation has been generally referred to as a single activity that is isolated from other rehabilitation processes in most literature [9][10][11], the experts felt it should be an integral part of the stroke survivors' assessment and treatment management plans. This position is similar to the report of Plant and Tyson [12] With regards to the implementation strategies, the multi-disciplinary team-based approach (MDT) was excluded, as experts felt that the interdisciplinary approach (IDT) was more suited for delivering the RTW intervention.…”

Section: Discussionmentioning

confidence: 99%

The Development of a Return to Work Intervention Programme for Stroke Survivor (SReTWIP): A Delphi Survey

Olaoye

Soeker

Rhoda

2019

Preprint

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Background Even though clearly defined pathways for vocational re-entry are well recognized for conditions such as mental health, musculoskeletal dysfunction and traumatic brain injury, none has been identified for stroke as there have been a lack of consensus regarding such clear pathways to vocational re-entry and the essential contents of RTW interventions for stroke survivors. As part of a larger study aimed to design a RTW programme for stroke survivors, this study described the concluding process through which Stroke Return to Work Intervention Programme (SReTWIP) was developed.Methods Experts in the field of neurorehabilitation and vocational rehabilitation (VR) from 6 countries participated in a 3-round Delphi survey by e-mail to design a RTW programme for stroke survivor. Concept mapping was used to triangulate findings from the Delphi with previous phases of the larger study. Content thematic analysis was conducted on quantitative data while descriptive statistic was used to analyse quantitative data.Results Fifteen experts with a mean age of 44.73±9.48 years and mean duration of practice of 18.26±8.71 years responded to this study. The developed RTW programme, SReTWIP, is a 12 week programme that consisted of four interconnected phases of intervention: an assessment phase, clinic-based work and non-work specific intervention phase, a work test placement phase and a client full participation in worker role phase. The panelist generally agreed on a set of implementation strategies that involve the use of interdisciplinary team, the tailoring of intervention to meet stroke survivor’s needs, as well as the use of case management approach.Conclusion The SReTWIP is the first step in developing a VR pathway that could ultimately enhance the RTW rates and quick resumption of the worker role of stroke survivors. The stroke survivor can move along the different phases of the SReTWIP after achieving competency in a preceding phase. Future work will include a feasibility study with other key stakeholders involved in RTW such as employers, informal caregivers and the stroke survivors before its implementation.

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“…Spasticity causes such alterations to gait that, even if a particular gait variable changes to a value closer to normal, this will not necessarily indicate a beneficial change. In the rehabilitation process of patients with spasticity, the goal is usually to develop, learn, or internalize a gait pattern that is as functional and harmless as possible considering anthropometric, muscular, or cognitive conditions, regardless of the normality of the pattern itself [7,[56][57][58]. Therefore, in an experiment like this one, it is necessary to interpret the results for each patient independently.…”

Section: Magnitude-based Decision (Mbd) To Monitor Individuals With Gait Analysismentioning

confidence: 99%

Is My Patient Improving? Individualized Gait Analysis in Rehabilitation

Marín

Blanco

et al. 2020

Applied Sciences

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In the rehabilitation field, clinicians are continually struggling to assess improvements in patients following interventions. In this paper, we propose an approach to use gait analysis based on inertial motion capture (MoCap) to monitor individuals during rehabilitation. Gait is a cyclical movement that generates a sufficiently large data sample in each capture session to statistically compare two different sessions from a single patient. Using this crucial idea, 21 heterogeneous patients with hemiplegic spasticity were assessed using gait analysis before and after receiving treatment with botulinum toxin injections. Afterwards, the two sessions for each patient were compared using the magnitude-based decision statistical method. Due to the challenge of classifying changes in gait variables such as improvements or impairments, assessing each patient’s progress required an interpretative process. After completing this process, we determined that 10 patients showed overall improvement, five patients showed overall impairment, and six patients did not show any overall change. Finally, the interpretation process was summarized by developing guidelines to aid in future assessments. In this manner, our approach provides graphical information about the patients’ progress to assess improvement following intervention and to support decision-making. This research contributes to integrating MoCap-based gait analysis into rehabilitation.

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Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Cited by 52 publications

References 34 publications

Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: feasibility assessment in survivors 12–24 months post-event

Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: feasibility assessment in survivors 12–24 months post-event

The Development of a Return to Work Intervention Programme for Stroke Survivor (SReTWIP): A Delphi Survey

Is My Patient Improving? Individualized Gait Analysis in Rehabilitation

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