Getting back to life after stroke: co-designing a peer-led coaching intervention to enable stroke survivors to rebuild a meaningful life after stroke

Abstract

Purpose: Rebuilding one's life after stroke is a key priority persistently identified by patients yet professionally led interventions have little impact. This co-design study constructs and tests a novel peer-led coaching intervention to improve post-stroke leisure and general social participation. Methods: This study followed the principles of co-design by actively engaging and harnessing the knowledge of stroke survivors in order to develop and test a peer-lead coaching intervention. Phase 1 assessed function, mood, and involvement in leisure and social activities 6 months following stroke (n ¼ 79). Phase 2 involved semi-structured, in-depth interviews with 18 stroke survivors, and 10 family carers to explore experiences related to social and leisure participation. Phase 3 tested the co-designed peer-led coaching intervention. Data collected also included co-design feedback sessions and a training workshop with selected peer coaches and in addition, interviews with stroke survivors and their peer coaches at two time-points: following the training program (n ¼ 5) and delivery of the intervention (n ¼ 2). Results: A peer-coaching intervention was successfully co-designed and tested combining the use of lay knowledge sociocognitive and self-regulatory theories with principles of transformational leadership theory. Both peers and stroke survivors reported having benefited at a personal level. Conclusions: This study reports on an innovative community-based and peer-led intervention and its results have generated new evidence on how stroke survivors engage with and respond to peer coaching support. It further provides a theoretical platform for designing and implementing peer interventions. Hence, these results have the potential to inform the development of future peer coaching intervention not only for stroke rehabilitation but also for a wide range of chronic conditions. ä IMPLICATIONS FOR REHABILITATIONThe results of this co-design study, if replicated and extended, provide a theoretical framework to guide rehabilitation professionals about the optimal timing of peer-coaching interventions and contextual factors that need to be taken into account. Applying transformational leadership theory principles to the training of peers may prove useful at the time of the implementation of a coaching intervention. Peer-led coaching interventions, which are community-based and tailored to stroke survivors at the time of discharge, may help support re-engagement in social and leisure activities.

An Integrative Review Considering the Impact of Storytelling and Sharing Interventions in Stroke

“…Fourteen studies were included in the integrated synthesis. This included six qualitative studies [ 29 , 30 , 31 , 32 , 33 , 34 ], two RCTs [ 35 , 36 ] and six mixed-method studies [ 37 , 38 , 39 , 40 , 41 , 42 ]. Figure 1 gives a full breakdown of the process of searching and identifying studies.…”

Feasibility of the Hand in Hand Relationship Intervention for Stroke Survivor–Caregiver Dyads: A Randomized Trial

“…The majority of people who experience a stroke survive the event (Virani et al, 2020). However, many are left with significant challenges including problems with balance and falls, bowel and bladder incontinence, difficulties with employment and recreational activities, and other social and emotional issues (Masterson-Algar et al, 2020; Schnitzler et al, 2019; Thomas et al, 2019; Xu et al, 2018). Systematic reviews report that approximately 31% of survivors experience depression at some point during the course of recovery (Hackett & Pickles, 2014; Hackett et al, 2005), compared with a slightly over 7% rate of major depression in the general U.S. adult population (National Institute of Mental Health, 2019).…”

Codesigning discharge communication interventions with healthcare providers, youth and parents for emergency practice settings: EDUCATE study protocol

“…Codesign is recognised as an important and effective approach for strengthening interventions that target healthcare practices. [64][65][66][67][68][69][70][71][72][73] Successful discharge communication in ED practice requires the active involvement of HCPs, parents or caregivers and patients. Including these relevant stakeholders in the design and usability testing of interventions to support discharge communication is particularly important given the interventions are likely to involve behaviour change.…”