Hazelton Christine, Harding Sam, Angilley Jayne, Palombi Alexandra, Bowen Audrey, Clatworthy Phil
Glasgow Caledonian University School of Health and Life Sciences, Glasgow, Scotland, UK.
Research and Development, North Bristol NHS Trust, Westbury on Trym, England, UK.
NIHR Open Res. 2025 Jul 4;5:57. doi: 10.3310/nihropenres.13984.1. eCollection 2025.
This study aimed to explore the barriers and facilitators of implementing rehabilitation interventions for visual field loss due to stroke.
The study was a qualitative exploration using one-to-one interviews coded using template analysis and the COM-B a-priori framework. Participants were five occupational therapists from hospital (n=4) and community (n=1) National Health Service (NHS) stroke care settings in England. The intervention experienced by the participant was a standardized goal-based visual scanning and search training for stroke survivors with visual field loss, delivered by occupational therapists (OTs), supported by information sheets and a dedicated website (HABIT).
HABIT provides a structured approach for delivering scanning and visual search training. HABIT resources aided participants' understanding and self-management. HABIT was considered similar to current practice as practiced by study participants and of most value to trainees and newly qualified therapists. However, resources had limited accessibility due to a lack of computer access and difficulty in reading text; modifications were required to make training activity examples more suitable for ward settings. Within ward settings, the delivery of HABIT was highly limited by time constraints; therapists ranked activities linked to safety and early discharge as higher priority. Clinicians noted that stroke survivors' lack of awareness of their visual loss and its impact limited their engagement with the HABIT, making delivery difficult.
Prioritization of vision rehabilitation in highly pressurized acute settings is a key factor in implementing HABIT. The findings will enable further refinement of HABIT content and delivery to address the barriers identified and improve its suitability in acute hospital settings.
本研究旨在探讨中风所致视野缺损康复干预措施实施过程中的障碍与促进因素。
本研究采用定性研究方法，通过一对一访谈收集数据，并使用模板分析和COM-B先验框架进行编码。参与者为来自英国国家医疗服务体系（NHS）中风护理机构的5名职业治疗师，其中4名来自医院，1名来自社区。参与者所经历的干预措施是由职业治疗师为患有视野缺损的中风幸存者提供的基于标准化目标的视觉扫描和搜索训练，并辅以信息表和专门网站（HABIT）的支持。
HABIT为提供扫描和视觉搜索训练提供了一种结构化方法。HABIT资源有助于参与者的理解和自我管理。HABIT被认为与研究参与者目前的实践类似，对实习生和新获得资格的治疗师最有价值。然而，由于缺乏计算机设备以及阅读文本困难，资源的可及性有限；需要进行修改，使训练活动示例更适合病房环境。在病房环境中，HABIT的实施受到时间限制的极大制约；治疗师将与安全和早期出院相关的活动列为更高优先级。临床医生指出，中风幸存者对其视力丧失及其影响缺乏认识，这限制了他们对HABIT的参与度，导致实施困难。
在压力巨大的急性病环境中对视力康复进行优先级排序是实施HABIT的关键因素。这些发现将有助于进一步完善HABIT的内容和实施方式，以克服所发现的障碍，并提高其在急性医院环境中的适用性。
