An appreciative action research (AAR) study to support the experience of multidisciplinary patient-centred approaches to stroke unit care and rehabilitation in hospitals.,.

Authors: Gordon, C., Ellis-Hill, C., Dewar, B. and Watkins, C.

Conference: 4th European Stroke Organisation Conference

Dates: 14-16 May 2018


Background/Aims United Kingdom stroke services have a national focus on service improvement through quantitative measures on processes of care. These measures do not account for the context or quality of care, and staff/patient/relative experiences. This study aims to identify and develop approaches to support positive stroke unit care experiences.

Method CG collaborated with two specialist stroke units in district hospitals in England. Using Appreciative Action Research , participants identified and developed approaches that support meaningful experiences for all participants. Participants included current stroke in-patients on stroke units (n=17), their relatives (n=7) and stroke unit team members (n=65). Data were generated over 20 months through 16 semi-structured interviews, observations of usual stroke unit care (213 hours) and 10 discussion groups. Data were co-analysed with participants, and themes developed on their most valued care experiences. Further in-depth analysis was conducted by the authors to confirm themes.

Results Sharing and reflecting on participants’ narratives of positive caring/rehabilitation experiences increased awareness of the network of human relationships supporting stroke care. Participants described that ‘pausing’ from physical tasks was essential order to connect with each other. This enabled staff to: • Focus on the person (patient, team member or relative) rather than the task • Understand each other’s’ perspectives, values and roles • Enable patients and relatives to influence care/rehabilitation focus Staff reported improved job satisfaction and wellbeing as a result of reflecting on positive caring narratives.

Conclusion Sharing and reflecting positive caring/rehabilitation narratives with patients, relatives and stroke unit team members can support the quality of care experience for all involved.

Source: Manual