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Designing a self-management intervention for stroke survivors with communication difficulties.

Wray, Faye Danielle (2017) Designing a self-management intervention for stroke survivors with communication difficulties. PhD thesis, University of Leeds.

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Abstract

Background: Stroke survivors with communication difficulties have poor outcome in the longer-term and may benefit from the support typically offered by self-management approaches. Aim: To critically examine the suitability of self-management as an approach for stroke survivors with communication difficulties and to use this knowledge to design an intervention to support stroke survivors with communication difficulties in the longer-term. Methods: Medical Research Council guidance for the development of complex interventions provided a framework for designing the intervention (MRC, 2008). In line with this guidance the intervention was designed iteratively using a staged approach. The design of the intervention was informed by a mixed methods systematic literature review and qualitative fieldwork undertaken with key stakeholders (stroke survivors with communication difficulties, carers and speech and language therapists). The Behaviour Change Wheel (BCW) provided a theoretical framework to identify which behaviours the intervention should target and appropriate behaviour change techniques. A Delphi survey was conducted to gain an expert consensus on the design of the intervention. Results: Stroke survivors with communication difficulties need further support to manage the consequences of their condition in the longer-term. Self-management may provide a structured and clearly defined intervention to support this group of stroke survivors with the challenges they face. However, existing self-management interventions do not address the needs of stroke survivors with communication difficulties and a condition specific self-management intervention is required. A novel self-management intervention for stroke survivors with communication difficulties was designed using the BCW as a theoretical framework. Feedback from an expert panel was used to refine the design of the intervention. Discussion: To the authors knowledge this is the first theoretically informed self-management intervention designed specifically for stroke survivors with communication difficulties. Further research is needed to develop the intervention. Future plans for feasibility testing and large-scale evaluation of the approach are discussed.

Item Type: Thesis (PhD)
Keywords: Self-management, Stroke, Complex Intervention, Aphasia, Dysarthria, Apraxia of Speech, Post-stroke communication difficulties
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Health Sciences (Leeds)
Identification Number/EthosID: uk.bl.ethos.745548
Depositing User: Faye Danielle Wray
Date Deposited: 03 Jul 2018 09:34
Last Modified: 18 Feb 2020 12:49
URI: http://etheses.whiterose.ac.uk/id/eprint/20839

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