Elf Marie, Klockar Erika, Kylén Maya, von Koch Lena, Ytterberg Charlotte, Wallin Lars, Finch Tracy, Gustavsson Catharina, Jones Fiona
School of Health and Welfare, Dalarna University, Falun, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
JMIR Res Protoc. 2022 May 6;11(5):e37672. doi: 10.2196/37672.
Self-management programs are recognized as a valuable approach to supporting people with long-term conditions, such as stroke, in managing their daily lives. Bridges Self-Management (Bridges) focuses on how practitioners interact and support patients' confidence, skills, and knowledge, and it is an example of a complex intervention. Bridges has been developed and used across multiple health care pathways in the United Kingdom and is theoretically informed by social cognition theory and self-efficacy principles. Evidence shows that self-management programs based on the construct of self-efficacy can be effective. There is still much to learn about how health care services or pathways should implement support for self-management in a sustainable way and whether this implementation process is different depending on the context or culture of the team or service provided.
The aim of this study is to tailor and evaluate an intervention (Bridges) to support self-management after stroke in a Swedish context.
We will use a pretest-posttest design with a case study approach to evaluate the feasibility and implementation of self-management support in two stroke settings. This project includes a complex intervention and depends on the actions of individuals, different contexts, and the adaptation of behavior over time. A mixed methods approach was chosen to understand both outcomes and mechanisms of impact. Data collection will comprise outcome measurements and assessment tools as well as qualitative interviews. Data will be collected concurrently and integrated into a mixed methods design.
Recruitment and data collection for the first site of the project ran from September 1, 2021, to January 17, 2022. The intervention at the first site was conducted from November 1, 2021, to March 5, 2022. The evaluation will start after the implementation phase. The second site has been recruited, and the baseline data collection will start in spring 2022. The intervention will start in early autumn 2022. Data collection will be completed by the end of 2022.
This study represents a unique, highly relevant, and innovative opportunity to maximize knowledge and minimize practice gaps in rehabilitation stroke care. The study will produce robust data on the intervention and in-depth data on the contextual factors and mechanisms related to the feasibility of the intervention and for whom it is feasible. Bridges has been used in the United Kingdom for more than 10 years, and this study will explore its contextualization and implementation within a Swedish stroke environment. The evaluation will study results at the patient, staff, and organizational levels and provide recommendations for the adoption and refinement of future efforts to support self-management.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37672.
自我管理项目被认为是支持患有中风等长期疾病的人管理日常生活的一种有价值的方法。桥梁自我管理（Bridges）专注于从业者如何与患者互动并增强其信心、技能和知识，它是一种复杂干预措施的范例。Bridges已在英国多个医疗保健途径中得到开发和应用，其理论基础是社会认知理论和自我效能原则。有证据表明，基于自我效能构建的自我管理项目可能是有效的。关于医疗保健服务或途径应如何以可持续的方式实施对自我管理的支持，以及这种实施过程是否因所提供团队或服务的背景或文化而异，仍有许多需要了解的地方。
本研究的目的是在瑞典背景下调整并评估一种干预措施（Bridges），以支持中风后的自我管理。
我们将采用前后测设计和案例研究方法，以评估在两种中风环境中自我管理支持的可行性和实施情况。该项目包括一项复杂干预措施，并且取决于个体的行为、不同的背景以及行为随时间的适应性。我们选择了一种混合方法来了解干预结果和影响机制。数据收集将包括结果测量、评估工具以及定性访谈。数据将同时收集并整合到混合方法设计中。
该项目第一个地点的招募和数据收集工作于2021年9月1日至2022年1月17日进行。第一个地点的干预于2021年11月1日至2022年3月5日实施。评估将在实施阶段结束后开始。第二个地点已完成招募，基线数据收集将于2022年春季开始。干预将于2022年秋初开始。数据收集将于2022年底完成。
本研究是一个独特、高度相关且具有创新性的机会，可最大限度地增加知识并最小化康复中风护理中的实践差距。该研究将产生关于干预措施的有力数据，以及关于与干预可行性相关的背景因素和机制的深入数据，以及确定该干预措施对哪些人可行。Bridges在英国已使用了10多年，本研究将探索其在瑞典中风环境中的情境化和实施情况。评估将在患者、工作人员和组织层面研究结果，并为未来支持自我管理的努力的采用和改进提供建议。
国际注册报告识别码（IRRID）：DERR1-10.2196/37672。
