Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Occupational Science and Occupational Therapy, University of British Columbia.
Phys Ther. 2019 Mar 1;99(3):286-296. doi: 10.1093/ptj/pzy146.
People who have had a stroke and are living in the community have low levels of physical activity, which reduces their functional capacity and increases risks of developing secondary comorbid conditions. Exercise delivered in community centers can address these low levels of physical activity; however, implementing evidence-based programs to meet the needs of all community stakeholders is challenging.
The objective of this study was to determine implementation factors to facilitate participation in relevant exercise and physical activity for people with chronic health conditions, like stroke.
The design consisted of a qualitative observational study using an integrated knowledge translation approach.
Supported by an integrated knowledge translation approach, a series of focus groups-with stakeholder group representation that included people who had had a stroke and care partners, community organizations (ie, support groups, community center staff), health care providers, and exercise deliverers-was conducted. During the focus groups, participants provided perspectives on factors that could influence implementation effectiveness. Focus groups were recorded, transcribed, and thematically analyzed.
Forty-eight stakeholders participated. Based on the themes, a new implementation model that describes the importance of relationships between community centers, clinicians, and people who have had a stroke is proposed. The development of partnerships facilitates the implementation and delivery of exercise programs for people with ongoing health needs. These partnerships address unmet needs articulated in the focus groups and could fill a gap in the continuity of care.
Data from this study support the need for the community sector to offer a continuing service in partnership with the health system and people with chronic health needs. It indicates the potential of clinicians to partner with people with chronic health conditions and empower them to improve participation in relevant health behaviors, like community-based exercise.
生活在社区中的中风患者身体活动水平较低，这降低了他们的身体机能，并增加了出现继发性合并症的风险。在社区中心进行的运动可以解决这些身体活动水平较低的问题；然而，实施基于证据的计划以满足所有社区利益相关者的需求具有挑战性。
本研究的目的是确定实施因素，以促进有慢性健康状况（如中风）的人参与相关的运动和身体活动。
该设计由使用综合知识转化方法的定性观察性研究组成。
在综合知识转化方法的支持下，进行了一系列焦点小组会议-有利益相关者群体的代表参加，包括中风患者和护理伙伴、社区组织（即支持小组、社区中心工作人员）、医疗保健提供者和运动提供者-参与者就可能影响实施效果的因素提供了观点。焦点小组会议进行了录音、转录和主题分析。
共有 48 名利益相关者参加。根据主题，提出了一个新的实施模型，描述了社区中心、临床医生和中风患者之间关系的重要性。合作伙伴关系的发展促进了针对有持续健康需求的人群的运动计划的实施和交付。这些合作伙伴关系满足了焦点小组中表达的未满足的需求，并可能填补了连续护理中的空白。
本研究的数据支持社区部门与卫生系统和有慢性健康需求的人合作提供持续服务的需求。它表明临床医生与有慢性健康状况的人建立合作伙伴关系并赋予他们提高参与相关健康行为（如社区运动）的潜力。
