Harrison Madeleine, Palmer Rebecca
a ScHARR, University of Sheffield , Sheffield , UK and.
b Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK.
Disabil Rehabil. 2015;37(23):2174-83. doi: 10.3109/09638288.2014.1001525. Epub 2015 Jan 19.
To explore the experiences of patients and carers involved in patient and public involvement (PPI) activities for stroke research.
Semi-structured interviews conducted with stroke survivors and carers (n = 11) were analysed using thematic analysis.
Four key themes emerged: impact of PPI on the individual and the research process, credibility and expertise, level of involvement and barriers and facilitators to PPI for stroke survivors and carers. The perceived benefits to the research process included: asking questions, keeping researchers grounded and directing the research agenda. All participants drew upon their experiential expertise in their PPI role, but some also drew upon their professional expertise to provide additional credibility. Stroke survivors and carers can be involved in PPI at different levels of involvement simultaneously and the majority of participants wanted to be more involved. Barriers to involvement included: location, transport and stroke survivors capacity to concentrate and comprehend complex information. Facilitators included: reimbursement for travel and time and professionals effort to facilitate involvement.
PPI in stroke research benefits stroke survivors and carers and is perceived to benefit the research process. The barriers and facilitators should be considered by professionals intending to engage stroke survivors and carers collaboratively in research.
This study has implications for PPI in stroke rehabilitation research, which could also be extrapolated to stroke rehabilitation service development and evaluation. Professionals facilitating PPI need to invest in developing supportive relationships in order to maintain ongoing involvement. Professionals need to be aware of how the varied consequences of stroke might impede participation and strategies to facilitate involvement for all who wish to be involved. For each rehabilitation issue being considered professionals need to decide: (1) how representative of the specific rehabilitation population the PPI members need to be, (2) whether experience alone is sufficient or whether additional professional skills are required and (3) whether training is likely to assist involvement or potentially reduce the lay representation.
探讨参与中风研究中患者及公众参与(PPI)活动的患者和护理人员的经历。
采用主题分析法对与中风幸存者及护理人员(n = 11)进行的半结构化访谈进行分析。
出现了四个关键主题:PPI对个人及研究过程的影响、可信度和专业知识、参与程度以及中风幸存者和护理人员参与PPI的障碍与促进因素。研究过程中感知到的益处包括:提出问题、使研究人员立足实际并指导研究议程。所有参与者在其PPI角色中都利用了自身的经验性专业知识,但有些人还利用其专业知识来增加可信度。中风幸存者和护理人员可以同时在不同参与程度上参与PPI,且大多数参与者希望更多地参与。参与的障碍包括:地点、交通以及中风幸存者集中精力和理解复杂信息的能力。促进因素包括:差旅和时间报销以及专业人员为促进参与所付出的努力。
中风研究中的PPI对中风幸存者和护理人员有益,且被认为对研究过程有益。打算让中风幸存者和护理人员合作参与研究的专业人员应考虑这些障碍与促进因素。
本研究对中风康复研究中的PPI有启示,这也可外推至中风康复服务的发展与评估。促进PPI的专业人员需要投入精力建立支持性的关系,以维持持续参与。专业人员需要意识到中风的各种后果可能如何阻碍参与,以及促进所有希望参与的人参与的策略。对于所考虑的每个康复问题,专业人员需要决定:(1)PPI成员需要在多大程度上代表特定的康复人群,(2)仅经验是否足够,还是需要额外的专业技能,以及(3)培训是否可能有助于参与,还是可能减少外行代表。