Designing a trial of early electrical stimulation to the stroke-affected arm: Qualitative findings on the barriers and facilitators
Designing a trial of early electrical stimulation to the stroke-affected arm: Qualitative findings on the barriers and facilitators
Introduction: This study aimed to explore the barriers and facilitators to implementing early therapeutic electrical stimulation (ES) treatment from both the patient and therapist perspectives as part of a feasibility study. Methods: Design: Interviews were conducted with patients and their carers and focus groups with the therapists post-intervention period. Setting: Interviews were in the patient’s homes and for the focus groups in a specialist stroke unit in Nottinghamshire. Subjects: Fifteen patient participants (34% of sample) were interviewed (intervention n = 9; control group n = 3; carers n = 3). Sixteen therapists (9 occupational therapists; 7 physiotherapists) took part in the three focus groups. Intervention: Participants were randomized to receive usual care or usual care and ES to wrist flexors and extensors for 30 min, twice a day, 5 days a week for 3 months. Findings: The barriers to ES treatment cited by the therapists outweighed the barriers mentioned by patients. Therapists’ barriers included lack of confidence and staff knowledge regarding ES and time pressures of delivering the ES. No patients mentioned time as a barrier and considered the treatment regime to be acceptable; however, lack of staff support was mentioned 14 times by them. Conclusion: Although initially the perceived barrier for therapists was time restrictions, after analysing the data, it appears that confidence/knowledge is the real barrier, and time is the manifestation of this underlying self-doubt. Patients were able to confidently self-manage treatment, and although efficacy was not measured, patients volunteered information regarding its perceived benefit, and no adverse effects were reported.
Electrical stimulation, qualitative, rehabilitation, stroke, trial design
Walker, Dawn Marie
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Fletcher-Smith, Joanna
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Sprigg, Nikola
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Pandyan, Anand
59bc84f5-b148-4947-8297-c53d5ae8d7a6
Walker, Dawn Marie
5d4c78b7-4411-493e-8844-b64efc72a1e8
Fletcher-Smith, Joanna
9985f72b-6089-4cc8-89f8-3567ae2a7a8c
Sprigg, Nikola
e3b7cfda-3b49-4c8f-b5cb-b13a77debaf9
Pandyan, Anand
59bc84f5-b148-4947-8297-c53d5ae8d7a6
Walker, Dawn Marie, Fletcher-Smith, Joanna, Sprigg, Nikola and Pandyan, Anand
(2021)
Designing a trial of early electrical stimulation to the stroke-affected arm: Qualitative findings on the barriers and facilitators.
British Journal of Occupational Therapy.
(doi:10.1177/03080226211008706).
Abstract
Introduction: This study aimed to explore the barriers and facilitators to implementing early therapeutic electrical stimulation (ES) treatment from both the patient and therapist perspectives as part of a feasibility study. Methods: Design: Interviews were conducted with patients and their carers and focus groups with the therapists post-intervention period. Setting: Interviews were in the patient’s homes and for the focus groups in a specialist stroke unit in Nottinghamshire. Subjects: Fifteen patient participants (34% of sample) were interviewed (intervention n = 9; control group n = 3; carers n = 3). Sixteen therapists (9 occupational therapists; 7 physiotherapists) took part in the three focus groups. Intervention: Participants were randomized to receive usual care or usual care and ES to wrist flexors and extensors for 30 min, twice a day, 5 days a week for 3 months. Findings: The barriers to ES treatment cited by the therapists outweighed the barriers mentioned by patients. Therapists’ barriers included lack of confidence and staff knowledge regarding ES and time pressures of delivering the ES. No patients mentioned time as a barrier and considered the treatment regime to be acceptable; however, lack of staff support was mentioned 14 times by them. Conclusion: Although initially the perceived barrier for therapists was time restrictions, after analysing the data, it appears that confidence/knowledge is the real barrier, and time is the manifestation of this underlying self-doubt. Patients were able to confidently self-manage treatment, and although efficacy was not measured, patients volunteered information regarding its perceived benefit, and no adverse effects were reported.
Text
03080226211008706
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More information
Accepted/In Press date: 15 February 2020
e-pub ahead of print date: 26 September 2021
Keywords:
Electrical stimulation, qualitative, rehabilitation, stroke, trial design
Identifiers
Local EPrints ID: 452148
URI: http://eprints.soton.ac.uk/id/eprint/452148
ISSN: 0308-0226
PURE UUID: 587d6a2a-fc3e-4555-ad5d-be8523c2c944
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Date deposited: 25 Nov 2021 20:51
Last modified: 17 Mar 2024 03:36
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Contributors
Author:
Dawn Marie Walker
Author:
Joanna Fletcher-Smith
Author:
Nikola Sprigg
Author:
Anand Pandyan
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