You don't understand ONE GODDAMN THING ABOUT SURVIVOR MOTIVATION, DO YOU? You create 100% recovery protocols and your survivor will be motivated to do the millions of reps needed because they are looking forward to 100% recovery. GET THERE!
The problem is stroke researchers are not motivated to solve stroke. What the fuck is your solution to that failure? We still don't know how to motivate stroke medical 'professionals' to solve stroke to 100% recovery!
Implementing ward-based practice books to increase the amount of practice completed during inpatient stroke rehabilitation: a mixed-methods process evaluation
To cite this article: Claire Stewart, Emma Power, Annie McCluskey, Suzanne Kuys & Meryl
Lovarini (22 Feb 2024): Implementing ward-based practice books to increase the amount
of practice completed during inpatient stroke rehabilitation: a mixed-methods process
evaluation, Disability and Rehabilitation, DOI: 10.1080/09638288.2024.2315502
To link to this article: https://doi.org/10.1080/09638288.2024.2315502
Lovarini (22 Feb 2024): Implementing ward-based practice books to increase the amount
of practice completed during inpatient stroke rehabilitation: a mixed-methods process
evaluation, Disability and Rehabilitation, DOI: 10.1080/09638288.2024.2315502
To link to this article: https://doi.org/10.1080/09638288.2024.2315502
Claire Stewarta, Emma Powerb,c, Annie McCluskeyc,d, Suzanne Kuyse and Meryl Lovarinic
aaustralasian Rehabilitation outcomes Centre, University of Wollongong, Wollongong, australia; bthe University of technology sydney, Graduate
school of health, sydney, australia; csydney school of health sciences, the University of sydney, sydney, australia; dthe strokeed Collaboration,
sydney, australia; eschool of allied health, australian Catholic University, banyo, australia
but spend many hours inactive during their rehabilitation. We conducted a mixed methods process
evaluation exploring factors affecting the success of a 6-month behaviour change intervention to
increase use of ward-based practice books.
Methods: Audits of the presence, quality and use of ward based-practice books were conducted,
alongside focus groups with staff (n = 19), and interviews with stroke survivors (n = 3) and family
members (n = 4). Quantitative data were analysed descriptively. Focus group and interview transcripts
were analysed using qualitative analysis.
Results: Personal (patient-related) factors (including severe weakness, cognitive and communication
deficits of stroke survivors), staff coaching skills, understanding and beliefs about their role, affected
practice book use. Staff turnover, nursing shift work and a lack of action planning reduced success of
the behaviour change intervention.
Conclusions: Staff with the necessary skills and understanding of their role in implementing ward practice
overcame personal (patient-related) factors and assisted stroke survivors to successfully practice on the ward.
To improve success of the intervention, repeated training of new staff is required. In addition to audit and
feedback, team action planning is needed around the presence, quality, and use of ward practice books.
h IMPLICATIONS FOR REHABILITATION
• Ward-based practice books are one evidence-based strategy that can be used by rehabilitation
teams to increase the amount of practice completed by stroke survivors during inpatient rehabilitation.
• Stroke survivors’ personal factors (including severe weakness, cognitive and communication deficits),
staff beliefs about their role and coaching skills, affected stroke survivors ability to practice on the
ward using practice books.
• Staff with the necessary skills, understanding and belief about their role in implementing ward
practice can overcome personal (patient related) factors (such as severe weakness) and assist stroke
survivors to successfully practice on the ward.
• To increase the success of ward practice, repeated booster training of staff is required along with audit
and feedback and team action planning on the presence, quality, and use of ward practice books
aaustralasian Rehabilitation outcomes Centre, University of Wollongong, Wollongong, australia; bthe University of technology sydney, Graduate
school of health, sydney, australia; csydney school of health sciences, the University of sydney, sydney, australia; dthe strokeed Collaboration,
sydney, australia; eschool of allied health, australian Catholic University, banyo, australia
ABSTRACT
Purpose: Stroke survivors must complete large amounts of practice to achieve functional improvementsbut spend many hours inactive during their rehabilitation. We conducted a mixed methods process
evaluation exploring factors affecting the success of a 6-month behaviour change intervention to
increase use of ward-based practice books.
Methods: Audits of the presence, quality and use of ward based-practice books were conducted,
alongside focus groups with staff (n = 19), and interviews with stroke survivors (n = 3) and family
members (n = 4). Quantitative data were analysed descriptively. Focus group and interview transcripts
were analysed using qualitative analysis.
Results: Personal (patient-related) factors (including severe weakness, cognitive and communication
deficits of stroke survivors), staff coaching skills, understanding and beliefs about their role, affected
practice book use. Staff turnover, nursing shift work and a lack of action planning reduced success of
the behaviour change intervention.
Conclusions: Staff with the necessary skills and understanding of their role in implementing ward practice
overcame personal (patient-related) factors and assisted stroke survivors to successfully practice on the ward.
To improve success of the intervention, repeated training of new staff is required. In addition to audit and
feedback, team action planning is needed around the presence, quality, and use of ward practice books.
h IMPLICATIONS FOR REHABILITATION
• Ward-based practice books are one evidence-based strategy that can be used by rehabilitation
teams to increase the amount of practice completed by stroke survivors during inpatient rehabilitation.
• Stroke survivors’ personal factors (including severe weakness, cognitive and communication deficits),
staff beliefs about their role and coaching skills, affected stroke survivors ability to practice on the
ward using practice books.
• Staff with the necessary skills, understanding and belief about their role in implementing ward
practice can overcome personal (patient related) factors (such as severe weakness) and assist stroke
survivors to successfully practice on the ward.
• To increase the success of ward practice, repeated booster training of staff is required along with audit
and feedback and team action planning on the presence, quality, and use of ward practice books
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