Bangor Institute for Health and Medical Research, School of Healthcare Sciences, Bangor University, Bangor, UK.
Faculty of Health Sport and Science, University of Stirling, Stirling, UK.
Disabil Rehabil. 2020 May;42(10):1359-1372. doi: 10.1080/09638288.2018.1524521. Epub 2018 Dec 3.
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. 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 ( = 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 ( = 5) and delivery of the intervention ( = 2). 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. 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.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.
中风后重建生活是患者一直强调的重点，但专业干预措施收效甚微。本项共同设计研究构建并测试了一种新的同伴主导的辅导干预措施，以改善中风后的休闲和一般社会参与度。本研究遵循共同设计原则，积极吸引和利用中风幸存者的知识，以开发和测试同伴主导的辅导干预措施。第 1 阶段在中风后 6 个月评估功能、情绪以及休闲和社会活动的参与度（ = 79）。第 2 阶段涉及对 18 名中风幸存者和 10 名家庭照顾者进行半结构化深入访谈，以探讨与社会和休闲参与相关的经验。第 3 阶段测试了共同设计的同伴主导的辅导干预措施。收集的数据还包括与选定的同伴教练进行的共同设计反馈会议和培训研讨会，此外，还在两个时间点对中风幸存者及其同伴教练进行了访谈：培训计划后（ = 5）和干预措施实施后（ = 2）。成功共同设计和测试了同伴辅导干预措施，该措施结合了使用非专业知识的社会认知和自我监管理论以及变革型领导理论的原则。同伴和中风幸存者都报告说个人受益。本研究报告了一种创新的基于社区和同伴主导的干预措施，其结果为了解中风幸存者如何接受和回应同伴辅导支持提供了新的证据。它进一步为设计和实施同伴干预措施提供了理论平台。因此，这些结果有可能为未来的中风康复以及广泛的慢性疾病的同伴辅导干预措施的发展提供信息。康复的意义如果复制和扩展本共同设计研究的结果，将为康复专业人员提供一个理论框架，指导他们关于同伴辅导干预的最佳时机以及需要考虑的背景因素。将变革型领导理论原则应用于同伴培训可能在实施辅导干预时有用。基于社区的、针对出院时中风幸存者量身定制的同伴主导的辅导干预措施，可能有助于支持重新参与社会和休闲活动。
