Lynch EA1,2, Harling RF3, Cadilhac DA2,4 and Harvey G1
1 University of Adelaide, South Australia, 2NHMRC Centre of Research Excellence in Stroke Rehabilitation & Brain Recovery, Victoria, 3Hampstead Rehabilitation Centre, CALHN, SA Health, 4Monash University, Victoria
Background: In 2018, more than one third of Australian inpatient rehabilitation centres providing care to people with stroke reported not adhering to the Stroke Clinical Guidelines and is not clear how to improve the delivery of evidence-based stroke rehabilitation. Less than 3% of research published in journals for stroke rehabilitation clinicians provides new knowledge about how to implement or evaluate evidence-based interventions.
Aim: To evaluate the feasibility and effectiveness of involving stroke survivors and carers in designing/delivering interventions that promote rehabilitation in line with the Stroke Clinical Guidelines.
Method: Recommendations from the Stroke Clinical Guidelines were prioritised according to the experiences and preferences of stroke survivors and their carers. The principles of experience-based codesign were applied, with former inpatients, carers and health professionals at one inpatient rehabilitation centre working collaboratively to design and tailor implementation strategies.
Results: Priorities for implementation identified by stroke survivors and carers were information provision, practice outside of therapy hours and nursing continuity. Stroke survivors, carers and health professionals from six disciplines participated in codesign workshops to identify how to address each recommendation in a way that met the needs of the stroke survivors and carers, while being feasible and sustainable for health professionals. Health professionals welcomed the opportunity to work collaboratively with former patients and unique insights were gained. Some stroke survivor and carer participants had difficulty attending face-to-face meetings, requiring workarounds such as teleconferencing with the research coordinator.
Conclusion: Codesign of implementation strategies with stroke survivors and their carers is feasible. Data regarding the effectiveness of the pilot trial will be available in February 2020.