Building Bridges between People with Stroke, Families, and Health Professionals: Development of a Blended Care Program for Self-Management

Author:

Mendes Pereira Carla12ORCID,Matos Mara1,Carvalho Daniel3,Macedo Patricia45ORCID,Calheiros José M.6ORCID,Alves Janice7ORCID,Paulino Ferreira Luís8,Dias Teresa L.1,Neves Madeira Rui49ORCID,Jones Fiona10

Affiliation:

1. Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal

2. Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, 1150-082 Lisbon, Portugal

3. Local Health Unit Litoral Alentejano (ULSLA), 7540-230 Santiago do Cacém, Portugal

4. Research Center for Engineering a Sustainable Development (Sustain.RD), Setúbal School of Technology, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal

5. Center of Technology and Systems (UNINOVA-CTS), NOVA School of Science and Technology, 2829-516 Caparica, Portugal

6. Institute for Research, Innovation and Development (FP-I3ID), University Fernando Pessoa, 4249-004 Porto, Portugal

7. Neurology Department, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal

8. Department of Psychiatry and Mental Health, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal

9. NOVA Laboratory of Computer Science and Informatics (NOVA LINCS), NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal

10. Population Health Research Institute, St George’s, University of London, London SW17 ORE, UK

Abstract

Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91–100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).

Funder

Fundação para a Ciência e Tecnologia

Publisher

MDPI AG

Reference72 articles.

1. Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019;Feigin;Lancet Neurol.,2021

2. Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., Burns, R., Rayner, M., and Townsend, N. (2017). European Cardiovascular Disease Statistics 2017, European Heart Network Brussels.

3. Long-Term Unmet Needs after Stroke: Systematic Review of Evidence from Survey Studies;Chen;BMJ Open,2019

4. Contextual Determinants of Participation after Stroke: A Systematic Review of Quantitative and Qualitative Studies;Viprey;Disabil. Rehabil.,2021

5. Enablers and Barriers in Hospital-to-Home Transitional Care for Stroke Survivors and Caregivers: A Systematic Review;Chen;J. Clin. Nurs.,2021

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