Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation

Abstract Background Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to ass...

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Main Authors: Randi Martinsen, Gabriele Kitzmüller, Margrete Mangset, Kari Kvigne, Anne Svelstad Evju, Berit Arnesveen Bronken, Line Kildal Bragstad, Ellen Gabrielsen Hjelle, Unni Sveen, Marit Kirkevold
Format: Article
Language:English
Published: BMC 2021-08-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-021-06857-8
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author Randi Martinsen
Gabriele Kitzmüller
Margrete Mangset
Kari Kvigne
Anne Svelstad Evju
Berit Arnesveen Bronken
Line Kildal Bragstad
Ellen Gabrielsen Hjelle
Unni Sveen
Marit Kirkevold
author_facet Randi Martinsen
Gabriele Kitzmüller
Margrete Mangset
Kari Kvigne
Anne Svelstad Evju
Berit Arnesveen Bronken
Line Kildal Bragstad
Ellen Gabrielsen Hjelle
Unni Sveen
Marit Kirkevold
author_sort Randi Martinsen
collection DOAJ
description Abstract Background Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to assist the persons and their families during the recovery and adjustment process. A home-based dialogical intervention aiming to enhance psychosocial support was therefore developed and tested in a randomized controlled trial. This study is a part of the process evaluation conducted alongside the trial. The aim was to explore the nurses’ and occupational therapists’ experiences of conducting the intervention. Methods Eighteen nurses and four occupational therapists participated in six focus groups to explore their experiences when providing the intervention. The themes discussed in the focus groups were the aspects that facilitated the delivering of the intervention and the challenges they encountered during the study period. The interviews were analysed using qualitative content analysis. Results The analysis generated two themes. The theme Developing a supportive relationship to facilitate the adjustment process following stroke had two subthemes: Getting personally involved and Handling challenges. This theme reveals how the nurses and occupational therapists experienced their relationship with the persons with stroke and potential threats which challenged them while conducting the intervention. The theme Developing professional skills in providing psychosocial support had two subthemes: Becoming confident in conducting dialogues and Integrating psychosocial topics. This theme reveals the aspects that the nurses and occupational therapists perceived as facilitating the development of their professional skills in conducting the dialogues. Conclusion Delivering the psychosocial intervention was perceived as deeply meaningful and increased the nurses’ and occupational therapists’ understanding of how to support stroke survivors to live with the consequences of stroke. However, balancing the professional and the personal relationship was challenging. A basic educational programme, training, supervision and having dedicated time were crucial elements to instil confidence in professionals conducting theme-based dialogues to promote post-stroke psychosocial well-being. Individual clinical experience and knowledge of stroke care were considering important to enable professionals to integrate psychosocial rehabilitation into community health care. Trial registration ClinicalTrials.gov, NCT 02338869 , registered 10/04/2014.
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spelling doaj.art-5d40c175b6e24a04ad351a49df23e2632022-12-21T18:46:28ZengBMCBMC Health Services Research1472-69632021-08-0121111010.1186/s12913-021-06857-8Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluationRandi Martinsen0Gabriele Kitzmüller1Margrete Mangset2Kari Kvigne3Anne Svelstad Evju4Berit Arnesveen Bronken5Line Kildal Bragstad6Ellen Gabrielsen Hjelle7Unni Sveen8Marit Kirkevold9Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied SciencesDepartment of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of NorwayDepartment of Geriatric Medicine, Oslo University HospitalDepartment of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied SciencesDepartment of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of NorwayDepartment of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied SciencesDepartment of Geriatric Medicine, Oslo University HospitalDepartment of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of OsloDepartment of Geriatric Medicine and Physical Medicine and Rehabilitation, Oslo University HospitalDepartment of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of OsloAbstract Background Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to assist the persons and their families during the recovery and adjustment process. A home-based dialogical intervention aiming to enhance psychosocial support was therefore developed and tested in a randomized controlled trial. This study is a part of the process evaluation conducted alongside the trial. The aim was to explore the nurses’ and occupational therapists’ experiences of conducting the intervention. Methods Eighteen nurses and four occupational therapists participated in six focus groups to explore their experiences when providing the intervention. The themes discussed in the focus groups were the aspects that facilitated the delivering of the intervention and the challenges they encountered during the study period. The interviews were analysed using qualitative content analysis. Results The analysis generated two themes. The theme Developing a supportive relationship to facilitate the adjustment process following stroke had two subthemes: Getting personally involved and Handling challenges. This theme reveals how the nurses and occupational therapists experienced their relationship with the persons with stroke and potential threats which challenged them while conducting the intervention. The theme Developing professional skills in providing psychosocial support had two subthemes: Becoming confident in conducting dialogues and Integrating psychosocial topics. This theme reveals the aspects that the nurses and occupational therapists perceived as facilitating the development of their professional skills in conducting the dialogues. Conclusion Delivering the psychosocial intervention was perceived as deeply meaningful and increased the nurses’ and occupational therapists’ understanding of how to support stroke survivors to live with the consequences of stroke. However, balancing the professional and the personal relationship was challenging. A basic educational programme, training, supervision and having dedicated time were crucial elements to instil confidence in professionals conducting theme-based dialogues to promote post-stroke psychosocial well-being. Individual clinical experience and knowledge of stroke care were considering important to enable professionals to integrate psychosocial rehabilitation into community health care. Trial registration ClinicalTrials.gov, NCT 02338869 , registered 10/04/2014.https://doi.org/10.1186/s12913-021-06857-8DialoguesExperiencesFocus groupsHealth care professionalsInterventionProcess evaluation
spellingShingle Randi Martinsen
Gabriele Kitzmüller
Margrete Mangset
Kari Kvigne
Anne Svelstad Evju
Berit Arnesveen Bronken
Line Kildal Bragstad
Ellen Gabrielsen Hjelle
Unni Sveen
Marit Kirkevold
Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
BMC Health Services Research
Dialogues
Experiences
Focus groups
Health care professionals
Intervention
Process evaluation
title Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
title_full Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
title_fullStr Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
title_full_unstemmed Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
title_short Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation
title_sort nurses and occupational therapists experiences of conducting a home based psychosocial intervention following stroke a qualitative process evaluation
topic Dialogues
Experiences
Focus groups
Health care professionals
Intervention
Process evaluation
url https://doi.org/10.1186/s12913-021-06857-8
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