http://etheses.whiterose.ac.uk/15385/
MPhil thesis, University of Sheffield.
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Dissertation Ying Man Law 4.2016.pdf Available under License Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 UK: England & Wales. Download (18Mb) | Preview |
Abstract
Aim: This
study aimed to develop a new stroke exercise manual to promote
self-managed rehabilitation with the support of available information
and communication technology and a new theoretical foundation for
functional physical stroke recovery in the community.
Background: Stroke is the biggest single cause of major disability
worldwide and is the single largest cause of adult disability in
England. Functional physical recovery continues over a long period of
time after stroke, thus, continuous support is essential. Limited
resources make it difficult to provide long-term face-to-face services.
Hence, there is a need to develop alternative approaches to enable
stroke survivors to self-manage their own exercises over the long-term;
such as self-managed exercise manual and the use of available
information and communication technologies (ICTs). Although the use of
physical exercises, self-management concepts and ICTs are shown to be
promising for stroke rehabilitation, little was known about integrating
them along with educational and technology related theories to empower
stroke survivors to manage their own exercise for their continued
physical functional rehabilitation in the community.
Methodology & Methods: This is a mixed methods research consisting
of 3 parts. The overall design of this research was based on the
user-centred design principle and the model of evidence-based clinical
decisions. The first part is the foundation phase in which literature
related to physical functional stroke rehabilitation, stroke
self-management and the use of ICTs for stroke rehabilitation were
reviewed. The second part is phase 1 in which semi-structured interviews
were conducted with community-dwelling stroke survivors with physical
disabilities, their carers, and physiotherapists and occupational
therapists who were purposively recruited to identify the components
required to develop the manual. It was verified and refined with the
interviewees using surveys. The third part is phase 2 in which a survey
was conducted with another group of therapists to evaluate the
acceptability, suitability, feasibility and safety of using the manual
from a professional perspective. Content thematic analysis was used to
analyse qualitative data collected from the interviews and
questionnaires. Descriptive statistical analysis was used to analyse
quantitative data collected in the surveys. A mixed methods matrix was
used to integrate and interpret both qualitative and quantitative data.
Findings: In foundation phase, seven types of exercise were identified
from the current evidence for physical functional stroke rehabilitation
which were included into the design of the new manual in this research
project. In phase 1, eight themes were generated from the interviews
with 18 stroke survivors and 8 of their carers. Six themes were
identified from 7 therapists. Findings were used to support a new
theoretical foundation called the “gear model” which consists of
self-efficacy theory, adult learning theory (andragogy), self-regulated
learning, motor learning theory and technology acceptance model to
suggest an integrated conceptual support to the design of the manual. A
refinement study was conducted with 15 interviewed stroke survivors and 6
therapists. The results indicate that the manual is understandable and
usable. It was evaluated with another group of 7 therapists in phase 2.
The results of the evaluation show that the manual is considered to be
acceptable, suitable, feasible and safe to be used from a professional
perspective. A conceptual framework was established using the themes and
selected theories to propose a way to use the manual in clinical
practice.
Conclusion: A new stroke exercise manual has been developed to suggest
an alternative approach for stroke survivors to manage their own
exercise for rehabilitation. Both theoretical and practical
considerations were involved in the development process of the manual.
Further research is required to examine the impact and value of the
manual for stroke rehabilitation. This research has contributed the
following new knowledge to the field of community stroke
rehabilitation:
1. Integrated theoretical foundation for the self-management of stroke
exercises with the support of using available ICTs called “Gear Model”
2. Knowledge about using ICTs that stroke survivors have and wish to use
for support
3. Process and components required to individualise a stroke exercise
manual with the support of available ICTs to promote self-managed
physical functional rehabilitation in the community
| Item Type: | Thesis (MPhil) |
|---|---|
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) |
| Depositing User: | Mr Ying Man Law |
| Date Deposited: | 18 Nov 2016 14:21 |
| Last Modified: | 18 Nov 2016 14:21 |
| URI: | http://etheses.whiterose.ac.uk/id/eprint/15385 |
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