How can we train stroke practitioners about patient self-management? Description and evaluation of a pathway wide training programme

Abstract

Objectives: This paper describes the evaluation of pathway-wide training for practitioners in a stroke self-management programme (SSMP). The Bridges SSMP teaches professionals to facilitate self-management skills in stroke survivors, using an individualised workbook. This was the first time professionals working throughout the stroke pathway received training together. The mixed-methods evaluation focused on the impact of Bridges training and the experiences of health and social care practitioners using the programme within the stroke pathway. It was informed by Normalisation Process Theory and Realist Evaluation. This paper discusses the need for a whole systems approach to stroke self-management, considering the patient, professional and organisational context to ensure sustainability in the longer term. Method: Semi-structured interviews were carried out with stroke practitioners before and after training, exploring their experiences of the stroke pathway, perceptions of self-management and experiences using Bridges. Content thematic analysis was used to categorise recurrent and common themes in the data. Questionnaires were completed before and after training, to evaluate participants’ change in beliefs, knowledge and practice of self-management. Results: Analysis of qualitative interviews and questionnaires revealed that participants were generally positive about Bridges. However, they reported specific challenges in delivering an SMP to stroke patients, which necessitated adaptations to their everyday practice and flexibility in strategies used. The majority of participants felt their practice had changed following the training and they were more mindful of using patient-led approaches. Conclusions: Evaluation revealed a number of positive findings and ideas for promoting sustainability of the SSMP in the longer term of direct relevance to patient self-management.