Research protocol: investigating the feasibility of a group self-management intervention for stroke (the GUSTO study)

Ella Clark,Fiona Jones,Nick S Ward,Gianluca Baio

doi:10.1186/s40814-017-0220-1

Abstract

BackgroundLife after stroke can be an ongoing struggle with over half of all survivors reporting unmet emotional and social needs. In the United Kingdom’s (UK) national clinical guidelines for stroke, self-management is suggested as one approach which can support long-term needs. In the UK NHS, self-management interventions are delivered in various ways. Regardless of the delivery mechanism, a tailored approach and ways to integrate peer support are advocated. Group delivery offers a platform for peer support and has the potential to remain individualised. However, before the efficacy of a group self-management intervention can be tested, the feasibility must be explored. This research investigates the feasibility of a GroUp Self-management intervention for sTrOke (GUSTO).MethodsA randomised waitlist control design will be used to investigate the feasibility of a group self-management intervention adapted from an existing one-to-one intervention called Bridges. A mixed methods approach will be used. Qualitative work will capture participant experience, while quantitative work will allow preliminary comparison between the intervention and waitlist groups (between subjects) and pre-post intervention measures (within subjects). Interviews will be conducted with stroke survivors and focus groups with family and friends to assess acceptability of the intervention.DiscussionThere is a growing interest in group-based self-management interventions for stroke as a method of supporting stroke survivors’ ongoing unmet needs. This is an area with limited research to date. This study will inform design of a fully powered trial which would assess the efficacy of a group self-management intervention following stroke.Trial registrationISRCTN19867168

Highlights

Life after stroke can be an ongoing struggle with over half of all survivors reporting unmet emotional and social needs
Question 5 will be answered through interviews conducted with stroke survivors who have attended the group selfmanagement intervention
Interest is growing in group self-management interventions as they may facilitate the long-term management of stroke, an area which is currently understudied

Summary

Introduction

Life after stroke can be an ongoing struggle with over half of all survivors reporting unmet emotional and social needs. In the United Kingdom’s (UK) national clinical guidelines for stroke, self-management is suggested as one approach which can support long-term needs. This research investigates the feasibility of a GroUp Self-management intervention for sTrOke (GUSTO). There are 1.2 million people living with the effects of stroke in the UK [1] These effects are varied, but over three quarters of survivors report limb weakness, half report unmet needs relating to social and emotional issues and a third report a communication disorder [1, 2]. In order to improve support for individuals living with chronic diseases such as stroke, health care professionals need to ‘abandon’ traditional ways of thinking [6]. For example, one way of supporting survivors increasingly

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