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Assistive technologies after stroke: self-management or fending for yourself? A focus group study

Assistive technologies after stroke: self-management or fending for yourself? A focus group study
Assistive technologies after stroke: self-management or fending for yourself? A focus group study
Background: assistive Technologies, defined as “electrical or mechanical devices designed to help people recover movement” have demonstrated clinical benefits in upper-limb stroke rehabilitation. Stroke services are becoming community-based and more reliant on self-management approaches. Assistive technologies could become important tools within self-management, however, in practice, few people currently use assistive technologies. This study investigated patients’, family caregivers and health professionals’ experiences and perceptions of stroke upper-limb rehabilitation and assistive technology use and identified the barriers and facilitators to their use in supporting stroke self-management.

Methods: a three-day exhibition of assistive technologies was attended by 204 patients, family caregivers/friends and health professionals. Four focus groups were conducted with people purposively sampled from exhibition attendees. They included i) people with stroke who had used assistive technologies (n?=?5), ii) people with stroke who had not used assistive technologies (n?=?6), iii) family caregivers (n?=?5) and iv) health professionals (n?=?6). The audio-taped focus groups were facilitated by a moderator and observer. All participants were asked to discuss experiences, strengths, weaknesses, barriers and facilitators to using assistive technologies. Following transcription, data were analysed using thematic analysis.

Results: all respondents thought assistive technologies had the potential to support self-management but that this opportunity was currently unrealised. All respondents considered assistive technologies could provide a home-based solution to the need for high intensity upper-limb rehabilitation. All stakeholders also reported significant barriers to assistive technology use, related to i) device design ii) access to assistive technology information and iii) access to assistive technology provision. The lack of and need for a coordinated system for assistive technology provision was apparent. A circular limitation of lack of evidence in clinical settings, lack of funded provision, lack of health professional knowledge about assistive technologies and confidence in prescribing them leading to lack of assistive technology service provision meant that often patients either received no assistive technologies or they and/or their family caregivers liaised directly with manufacturers without any independent expert advice.

Conclusions: considerable systemic barriers to realising the potential of assistive technologies in upper-limb stroke rehabilitation were reported. Attention needs to be paid to increasing evidence of assistive technology effectiveness and develop clinical service provision. Device manufacturers, researchers, health professionals, service funders and people with stroke and family caregivers need to work creatively and collaboratively to develop new funding models, improve device design and increase knowledge and training in assistive technology use
stroke, upper limb, assistive technology, self-management, patient, family caregivers, health care professional, rehabilitation, qualitative research
1472-6963
334
Demain, Sara
09b1124d-750a-4eb1-90c7-91f5f222fc31
Burridge, Jane
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Ellis-Hill, Caroline
8869242e-5047-4127-a63e-00858ff5a993
Hughes, Ann-Marie
11239f51-de47-4445-9a0d-5b82ddc11dea
Yardley, Lucy
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Tedesco-Triccas, Lisa
d9c14d0b-831a-4b60-bf8c-4a5c1816f10c
Swain, Ian
c300c5a1-a4db-4a89-9d7a-9cf7dd0cd83b
Demain, Sara
09b1124d-750a-4eb1-90c7-91f5f222fc31
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Ellis-Hill, Caroline
8869242e-5047-4127-a63e-00858ff5a993
Hughes, Ann-Marie
11239f51-de47-4445-9a0d-5b82ddc11dea
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Tedesco-Triccas, Lisa
d9c14d0b-831a-4b60-bf8c-4a5c1816f10c
Swain, Ian
c300c5a1-a4db-4a89-9d7a-9cf7dd0cd83b

Demain, Sara, Burridge, Jane, Ellis-Hill, Caroline, Hughes, Ann-Marie, Yardley, Lucy, Tedesco-Triccas, Lisa and Swain, Ian (2013) Assistive technologies after stroke: self-management or fending for yourself? A focus group study. BMC Health Services Research, 13 (1), 334. (doi:10.1186/1472-6963-13-334). (PMID:23968362)

Record type: Article

Abstract

Background: assistive Technologies, defined as “electrical or mechanical devices designed to help people recover movement” have demonstrated clinical benefits in upper-limb stroke rehabilitation. Stroke services are becoming community-based and more reliant on self-management approaches. Assistive technologies could become important tools within self-management, however, in practice, few people currently use assistive technologies. This study investigated patients’, family caregivers and health professionals’ experiences and perceptions of stroke upper-limb rehabilitation and assistive technology use and identified the barriers and facilitators to their use in supporting stroke self-management.

Methods: a three-day exhibition of assistive technologies was attended by 204 patients, family caregivers/friends and health professionals. Four focus groups were conducted with people purposively sampled from exhibition attendees. They included i) people with stroke who had used assistive technologies (n?=?5), ii) people with stroke who had not used assistive technologies (n?=?6), iii) family caregivers (n?=?5) and iv) health professionals (n?=?6). The audio-taped focus groups were facilitated by a moderator and observer. All participants were asked to discuss experiences, strengths, weaknesses, barriers and facilitators to using assistive technologies. Following transcription, data were analysed using thematic analysis.

Results: all respondents thought assistive technologies had the potential to support self-management but that this opportunity was currently unrealised. All respondents considered assistive technologies could provide a home-based solution to the need for high intensity upper-limb rehabilitation. All stakeholders also reported significant barriers to assistive technology use, related to i) device design ii) access to assistive technology information and iii) access to assistive technology provision. The lack of and need for a coordinated system for assistive technology provision was apparent. A circular limitation of lack of evidence in clinical settings, lack of funded provision, lack of health professional knowledge about assistive technologies and confidence in prescribing them leading to lack of assistive technology service provision meant that often patients either received no assistive technologies or they and/or their family caregivers liaised directly with manufacturers without any independent expert advice.

Conclusions: considerable systemic barriers to realising the potential of assistive technologies in upper-limb stroke rehabilitation were reported. Attention needs to be paid to increasing evidence of assistive technology effectiveness and develop clinical service provision. Device manufacturers, researchers, health professionals, service funders and people with stroke and family caregivers need to work creatively and collaboratively to develop new funding models, improve device design and increase knowledge and training in assistive technology use

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More information

Published date: 22 August 2013
Keywords: stroke, upper limb, assistive technology, self-management, patient, family caregivers, health care professional, rehabilitation, qualitative research
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 356589
URI: http://eprints.soton.ac.uk/id/eprint/356589
ISSN: 1472-6963
PURE UUID: 0c569511-ab14-4978-b871-8b730c070ace
ORCID for Jane Burridge: ORCID iD orcid.org/0000-0003-3497-6725
ORCID for Ann-Marie Hughes: ORCID iD orcid.org/0000-0002-3958-8206
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 16 Sep 2013 12:26
Last modified: 15 Mar 2024 03:25

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Contributors

Author: Sara Demain
Author: Jane Burridge ORCID iD
Author: Caroline Ellis-Hill
Author: Lucy Yardley ORCID iD
Author: Lisa Tedesco-Triccas
Author: Ian Swain

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