scholarly journals Strengthening nursing role and functions in stroke rehabilitation 24/7: A mixed-methods study assessing the feasibility and acceptability of an educational intervention programme

Nursing Open ◽  
2018 ◽  
Vol 6 (1) ◽  
pp. 162-174 ◽  
Author(s):  
Mia Ingerslev Loft ◽  
Ingrid Poulsen ◽  
Bente Martinsen ◽  
Lone Lunbak Mathiesen ◽  
Helle Klingenberg Iversen ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Educational Intervention ◽  
Stroke Rehabilitation ◽  
Mixed Methods Study ◽  
Intervention Programme ◽  
Nursing Role

scholarly journals Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study

10.2196/14629 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e14629
Author(s):  
Dorra Rakia Allegue ◽  
Dahlia Kairy ◽  
Johanne Higgins ◽  
Philippe Archambault ◽  
Francois Michaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Mixed Methods ◽  
Upper Extremity ◽  
Shared Decision Making ◽  
Stroke Rehabilitation ◽  
Mixed Methods Study ◽  
Decision Making Process ◽  
Shared Decision

Background Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant’s completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. Objective This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. Methods A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. Results At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. Conclusions This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. Trial Registration ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. International Registered Report Identifier (IRRID) DERR1-10.2196/14629

scholarly journals Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Dorra Rakia Allegue ◽  
Dahlia Kairy ◽  
Johanne Higgins ◽  
Philippe Archambault ◽  
Francois Michaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Mixed Methods ◽  
Upper Extremity ◽  
Shared Decision Making ◽  
Stroke Rehabilitation ◽  
Mixed Methods Study ◽  
Decision Making Process ◽  
Shared Decision

BACKGROUND Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant’s completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. OBJECTIVE This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. METHODS A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. RESULTS At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. CONCLUSIONS This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. CLINICALTRIAL ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14629

scholarly journals Determining the Impacts of Educational Intervention based on PLST Extended Care model on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

2021 ◽  
Author(s):  
Fereshteh Zamani-Alavijeh ◽  
Shakiba Zahed ◽  
Maryam Emami ◽  
Shahrzad Bazargan-Hejazi ◽  
Majid Barekatain ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Educational Intervention ◽  
Intervention Program ◽  
Challenging Behaviors ◽  
Mixed Methods Study ◽  
Care Model ◽  
People With Dementia ◽  
Stress Threshold ◽  
Progressively Lowered Stress Threshold ◽  
The Mean

Abstract Background: Psychological events in People with Dementia (PWD) lead to behavioral disorders which require targeted planning for caregivers on how to adapt to these behaviors. Progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of People with Dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered Stress threshold extended (PLSTE) model on the caregiving of People with Dementia (PWD) in Isfahan, Iran. Methods: This exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth non-structured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command in a word and then analyzed. The researcher designed a multi-sectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by the panel of experts and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. The data were collected immediately and one month after the educational intervention using a questionnaire. Results: According to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class, and then the related Intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).Conclusion: Considering the impacts of this intervention, educating the caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of the society, to improve knowledge and practice of caregivers in caregiving skills and appropriate exposure to Challenging Behaviors People with Dementia (CBPWD).

A multi-professional educational intervention to improve and sustain respondents’ confidence to deliver palliative care: A mixed-methods study

2017 ◽  
Vol 32 (2) ◽  
pp. 571-580 ◽  
Author(s):  
Elizabeth Reed ◽  
Jennifer Todd ◽  
Sally Lawton ◽  
Robert Grant ◽  
Clair Sadler ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Educational Intervention ◽  
Mixed Methods Study

scholarly journals Changing professional behaviours: mixed methods study utilising psychological theories to evaluate an educational programme for UK medical doctors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asta Medisauskaite ◽  
Ann Griffin ◽  
Rowena Viney ◽  
Ahmed Rashid ◽  
Antonia Rich
Keyword(s):  
Mixed Methods ◽  
Reflective Practice ◽  
Educational Intervention ◽  
Perceived Control ◽  
Qualitative Interviews ◽  
Education Programme ◽  
Subjective Norms ◽  
Mixed Methods Study ◽  
Control Group ◽  
Post Intervention

Abstract Background The Theory of Planned Behaviour (TPB) has been proposed as a useful framework to investigate professional behaviour, however, was not yet applied to the evaluation of an educational intervention. This study will address this gap by utilising the TPB to evaluate the effectiveness of an education programme delivered by the professional regulator for UK doctors in enhancing three professional behaviours: raising concerns, engaging in reflective practice, and use of regulator confidentiality guidance. Methods This is a comprehensive mixed methods study combining qualitative (interviews) and quantitative (quasi-experiment) data. Intervention participants were asked to complete a survey measuring the variables in the TPB (attitudes, subjective norms, perceived behavioural control, and intention) for the three professional behaviours before, immediately post, and 3-months later following the education programme. Ninety-four doctors completed the survey pre/post intervention and 38 at all three times. One hundred and eleven doctors from the same hospital trust who did not take part in the intervention completed the survey at two time points and formed the control group. Forty-two interviews were conducted with intervention participants. Results The quantitative study revealed that the educational intervention significantly improved attitudes (raising concerns, using confidentiality guidance), subjective norms (raising concerns, reflective practice, using confidentiality guidance), perceived control (raising concerns, using confidentiality guidance), and intentions (using confidentiality guidance) (Group and Time interaction; Fs ≥ 3.996, ps ≤ .047, ηp2 ≥ .020). Non-UK graduate doctors’ subjective norms towards raising concerns and confidentiality guidance increased significantly after the intervention (Fs ≤ 6.602, ps ≥ .011, ηp2 = .032 F = 6.602, p = .011, ηp2 = .032), but not UK graduates (p > .05). Interviews revealed that doctors had positive views about professional behaviours but also mentioned numerous barriers to actually engage in more complex, context dependent behaviours. Conclusions This study demonstrates that an educational intervention was successful in improving the TPB variables of three professional behaviours. It also revealed that teaching professionalism does not happen in isolation and, therefore, personal and contextual factors are crucial to consider. To change complex professional behaviours, barriers at all levels i.e., personal, organisational and system, should be addressed.

scholarly journals A mixed-methods study to explore opinions of research translation held by researchers working in a Centre of Research Excellence in Australia

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022357 ◽  
Author(s):  
Elizabeth A Lynch ◽  
Shanthi A Ramanathan ◽  
Sandy Middleton ◽  
Julie Bernhardt ◽  
Michael Nilsson ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Stroke Rehabilitation ◽  
Research Impact ◽  
Interview Data ◽  
Mixed Methods Study ◽  
Research Translation ◽  
Stroke Research ◽  
Semistructured Interviews ◽  
Research Excellence

ObjectiveThere is a growing need for researchers to demonstrate impact, which is reliant on successful research translation. The Australian National Health and Medical Research Council funded a Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery (CRE-Stroke) to enhance collaborations between researchers conducting different types of stroke rehabilitation research. The purpose of this study was to explore opinions about research translation held by CRE-Stroke researchers conducting preclinical and clinical research, in terms of scope, importance, responsibility and perceived skills and knowledge.DesignMixed-methods study, comprising a paper-based survey and semistructured interviews. Interview data were inductively coded and thematically analysed. Survey and interview data were compared and synthesised.Participants55 (7 preclinical, 48 clinical) researchers attending a CRE-Stroke research forum completed a paper-based survey. Semistructured interviews with 22 CRE-Stroke (5 preclinical, 17 clinical) researchers were conducted.ResultsResearch translation was described as translating to other research and translating to clinical practice and policy. Most researchers (n=54, 98%) reported that research translation was important, particularly in terms of generating research impact, but the most common sign of project completion reported by researchers (n=7, 100% preclinical; n=37, 77% clinical) was publication. Most researchers (preclinical n=4, 57%; clinical n=37, 77%) reported having responsibility for translating research, but less than half reported having the necessary skills (n=1, 14% preclinical; n=17, 35% clinical) and knowledge (n=3, 43% preclinical; n=19, 40% clinical). Differing opinions about who should be responsible for translating findings to clinical practice were expressed.ConclusionsStroke rehabilitation researchers appear confident to translate their research via the traditional mechanism of publications. To optimise impact, clarity is needed regarding who is best placed to translate research findings to clinical practice and policy. Education and skills development to apply broader translation processes are needed to maximise the use of research at all stages.

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