“I’m just not a Sudoku person”: analysis of stroke survivor, carer, and healthcare professional perspectives for the design of a cognitive rehabilitation intervention

Abstract

Exploring the views of those impacted by stroke is key to the design of an effective and appropriate cognitive rehabilitation intervention for post-stroke cognitive impairment. This qualitative study examined the perspectives and preferences of stroke survivors, carers, and healthcare professionals to inform the design of a cognitive rehabilitation intervention. Design & MethodsThe research employed a qualitative study design and thematic analysis of data. In-depth semi-structured interviews were conducted with stroke survivors (n=14), carers (n=11), and healthcare professionals involved in providing stroke care (n=19). Interviews were audio-recorded and transcribed. Coding was conducted and themes were developed both inductively and deductively. ResultsThemes address five broad areas relevant for the design and implementation of the intervention: i) activities to include; ii) when it takes place; iii) location; vi) format; v) who the intervention should include. ConclusionsQualitative work with stroke survivors, carers and healthcare professionals provided vital information for the intervention design. Issues identified by participants as being key to intervention development included: i) implications of post-stroke cognitive impairment survivors' confidence; ii) their individual capacity in terms of fatigue and metacognition; and iii) practical issues such as intervention location. The inclusion of psychoeducation regarding consequences of stroke was recommended.

The Cognition and Flow Study (CogFlowS): A Mixed Method Evaluation of A Randomised Feasibility Trial of Cognitive Training in Dementia

“…These results suggest an individualised approach should be taken, particularly assessing for and addressing potential barriers. This requirement for a personalised approach is echoed by qualitative studies previously investigating cognitive interventions in people living with stroke [30], MCI [31] and dementia [12]. Lack of insight has previously been identi ed as a barrier to successful cognitive rehabilitation in patients with HIV and schizophrenia associated cognitive impairment [9].…”

Exploring the perspectives of key stakeholders on the design and delivery of a cognitive rehabilitation intervention for people post-stroke

“…A previous qualitative enquiry gathered the perspectives of key stakeholders on the design of a cognitive rehabilitation intervention post-stroke, focusing solely on psychological interventions [ 27 ]. This previous qualitative study was underpinned by a systematic review of non-randomised controlled studies of psychological interventions [ 28 ] and highlighted the need for improving confidence and self-efficacy in the management of cognitive impairment post-stroke, in addition to the importance of effective information provision on stroke sequalae and psychoeducation regarding the consequences of stroke [ 27 ].…”

“…A previous qualitative enquiry gathered the perspectives of key stakeholders on the design of a cognitive rehabilitation intervention post-stroke, focusing solely on psychological interventions [ 27 ]. This previous qualitative study was underpinned by a systematic review of non-randomised controlled studies of psychological interventions [ 28 ] and highlighted the need for improving confidence and self-efficacy in the management of cognitive impairment post-stroke, in addition to the importance of effective information provision on stroke sequalae and psychoeducation regarding the consequences of stroke [ 27 ]. In contrast to the qualitative enquiry of Merriman et al [ 27 ], the current study elicits perspectives on all types of non-pharmacological rehabilitation interventions, not only psychological interventions, for cognitive impairment post-stroke, as evidenced from our previous systematic review [ 26 ].…”

The Prevalence of Cognitive Impairment on Admission to Nursing Home among Residents with and without Stroke: A Cross–Sectional Survey of Nursing Homes in Ireland

“…It is estimated that, in the first year following stroke, 26.5% of stroke survivors have dementia, and 38% of survivors experience cognitive impairment that does not meet the criteria for dementia (cognitive impairment no dementia (CIND)) [ 5 , 6 ]. Yet post–stroke cognitive impairment (PSCI) is an often overlooked consequence of stroke [ 5 , 6 , 7 , 8 ]. While there is a considerable body of knowledge surrounding interventions to improve physical function post–stroke, there is significantly less research dedicated to cognitive impairment [ 7 , 9 ].…”

“…Yet post–stroke cognitive impairment (PSCI) is an often overlooked consequence of stroke [ 5 , 6 , 7 , 8 ]. While there is a considerable body of knowledge surrounding interventions to improve physical function post–stroke, there is significantly less research dedicated to cognitive impairment [ 7 , 9 ]. Indeed, understanding and reducing cognitive impairment post–stroke is regarded as “the single most important topic in stroke research” [ 10 , 11 , 12 ].…”