JMIR Publications

ABSTRACT

Background:

Self-management programmes 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 healthcare pathways in the UK and is theoretically informed by self-efficacy principles. Evidence shows that self-management programmes based on the concept of self-efficacy are effective. There is still much to learn about how healthcare 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.

Objective:

To tailor and evaluate an intervention (Bridges) developed in the UK to support self-management after stroke in a Swedish context.

Methods:

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. The current project includes a “complex intervention” and depends on the actions of individuals, different contexts, and the adaptation of behaviour over time. A mixed-method approach was chosen to understand both outcomes and mechanisms of impact. The data collection will comprise outcome measurements/assessment tools and qualitative interviews. Data will be collected concurrently and integrated into a mixed-method design.

Results:

The study has opened for recruitment. Data collection will be completed by the end of 2022.

Conclusions:

This study represents a unique, highly relevant, and innovative opportunity to minimize knowledge and 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 for whom and how the intervention is feasible. The intervention (Bridges) has been used in the UK for more than ten 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.