Bridges research and development projects

Developing and evaluating Bridges stroke self-management in a group setting

Bridges self-management programme has always been delivered as a one to one approach integrated into rehabilitation and care. But could it work equally as well in a group setting? Prof Fiona Jones is collaborating with Dr Nick Ward, and Ella Clark from Queens Square, University College London, in the first study of its kind to explore the feasibility of using Bridges self-management programme for people post stroke in groups. The project is funded by Research for Patient Benefit, NIHR and will run from March 2015 for 3 years.

During the first stage of this project 14 stroke survivors took part in interviews where they were asked about:

1) Possible benefits of a group self-management programme

2) Possible challenges of a group self-management programme, and

3) When and where to implement a self-management programme in an individual’s post-stroke journey.

Three main themes were identified from the interview data:

1) A space to share support, with a focus on group interactions

2) Stroke is not a ‘one size fits all problem’ and consequently a group programme should be tailored to each individual, and

3) How is this going to happen? Logistics and group facilitators.

A further focus group was held and the research team developed a stroke self-management programme lasting 4 weeks, incorporating stroke survivors’ views and Bridges self-management principles and tools.   We are now testing the feasibility of delivering this 4-week programme to stroke survivors. We are aiming to run 8 groups, working with around 60 stroke survivors.

Feedback from stroke survivors participating in the programme has been positive, with some individuals continuing to meet up after the groups have ended.  Stroke survivors have enjoyed meeting others who have a shared experience, and enjoy hearing how everyone is getting on each week. The addition of a stroke survivor facilitator has been a great success with many specifically mentioning how inspiring this has been.

The fidelity of the intervention will be evaluated using process evaluation, in which we will explore facilitator experiences, the particular the Bridges concepts being used and any missed opportunities, and whether any additional change mechanisms are revealed. This work will be done with the help of Zula Haigh, Speech and Language Therapist who is co-facilitating the group sessions, and Katie Eves, a Physiotherapy student who records what is happening at each group session.

The project team will look at the quantitative outcomes of the group (quality of life, activities of daily living, anxiety and depression, and self-efficacy) as well as qualitative outcomes (experiences of the group). The team will also report the feasibility of the group program, including recruitment rates, attendance, and the effect sizes for the outcome measures.  If successful, this work could develop into a fully powered randomised control trial to look at the efficacy of Bridges self-management programme in a group setting.

For more information contact Ella Clark.

There are blog posts about this research from Ella Clark and Billy Mann, one of the stroke survivor facilitators.

We have also published an article in a scientific journal, which you can view here.