Goal-setting in Stroke: From Guideline Towards Implementation: a Realist Evaluation
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 280
- 试验地点
- 1
- 主要终点
- Adoption and adherence of goal-setting programme- in acute care setting
研究概览
简要总结
Overall objective: The aim of the project is to integrate the quality improvement programme on goal setting into the current care of people with stroke and to test and refine this programme.
Target group:
- People after a stroke (treatment in the participating centres); total number 155 people
- Informal carers (only if the person has had a stroke and has limited opportunities to participate)
- Professional carer; total number 155 people
What?
The goal-setting programme becomes standard care, it is checked whether the programme has been applied in care by health professionals (review of the patient's medical record), what the effects are on patients (questionnaires) and health professionals (questionnaires) and whether the quality improvement programme needs to be adjusted or refined (interviews with health professionals and the patient group)
When to evaluate?
- Health professionals: start of the study and end of the study via questionnaires. Interviews/focus group (every 3 months)
- Review of patient records and observations (every 3 weeks)
- Patient assessment: Admission and 1 week before discharge or end of study, Interviews/focus group (3 months)
详细描述
Aim This study aims to evaluate the implementation of a quality improvement program to improve goal-setting in the rehabilitation process after a stroke event (further referred to as goal-setting programme) by means of a realist evaluation.
During this project, following questions will be answered:
What are the different elements and the final form of the initial goal-setting programme? How is goal-setting for the implementation of the goal-setting programme conducted? How is the goal-setting programme implemented? Is the goal-setting programme accepted, is it appropriate and feasible to implement? (review the implementation process).
Are adjustments needed on the goal-setting programme? How are the adjustments in the goal-setting programme being followed up? (review the implementation process) Does the implementation of the goal-setting programme in healthcare have an effect for patient or professional healthcare providers? (patient and healthcare professional outcome: Satisfaction with stroke care, participation, emotional status, empowerment and quality of life and overall feeling on goal-setting in stroke care)
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Professional healthcare providers
- •Inclusion criteria:
- •Participants are employed in hospitals, rehabilitation centres and/or private practices/primary healthcare facilities located in the provinces: Province of Flemish Brabant, Brussels, Province of Walloon Brabant, Limburg
- •Participants have a social, medical profession/background, work in the management of healthcare services or quality of healthcare
- •Participants involved (direct or indirect) in the goal-setting process of the patients
- •Participants who master the Flemish or French language
- •Adult participants (≥18 years)
排除标准
- •Not giving informed consent
- •Inclusion criteria:
- •Participants after a stroke event.
- •Residence in one of the four participating sites, in outpatient care or receive treatment in first line zone
- •Participants who master the Flemish or French language
- •Adult participants (≥18 years)
- •Exclusion criteria:
- •Not giving informed consent
- •Other severe comorbidities that interfere with the rehabilitation process or goal-setting process
- •Informal caregivers
- •Inclusion criteria:
- •Informal caregiver of a stroke patient admitted to one of the four participating sites
研究组 & 干预措施
People after a stroke event
Implementation of improvement program
干预措施: Goal setting improvement program (Procedure)
Healthcare professionals
Implementation of improvement program
干预措施: Goal setting improvement program (Procedure)
Close relatives of people after a stroke
Implementation of improvement program
干预措施: Goal setting improvement program (Procedure)
结局指标
主要结局
Adoption and adherence of goal-setting programme- in acute care setting
时间窗: Once up to 3 weeks during the hospitalisation period, through study completion, an average of 1 year
The medical record screens whether all points of the predetermined goal setting programme are carried out and noted in the medical record.
Adoption and adherence of goal-setting programme- in rehabilitation setting
时间窗: Every 3 weeks during the hospitalisation period, through study completion, an average of 1 year
The medical record screens whether all points of the predetermined goal setting programme are carried out and noted in the medical record.
次要结局
- Evaluation of patient/ informal caregivers: Measuring patient satisfaction with stroke care(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of patient/ informal caregivers, general Self-Efficacy(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of professional healthcare providers; Acceptability of Intervention Measure, Intervention Appropriateness Measure, & Feasibility of Intervention Measure questionnaire(1-2 months after study start, at 4 months after study start and immediately after the intervention)
- Evaluation of patient/ informal caregivers, Patient empowerment:(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of patient/ informal caregivers: Patient Participation(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of patient/ informal caregivers, Level of depression:(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of patient/ informal caregivers, stroke self-efficacy:(Baseline and immediately after the intervention/admission to the healthcare institution)
- Evaluation of professional healthcare providers: Satisfaction of employees in healthcare(Baseline and immediately after the intervention)
- Evaluation of professional healthcare providers; Self- efficacy(Baseline and immediately after the intervention)
- Feedback on the goal setting programme and implementation strategies.(2-3, 5 and 8 months after study start.)
研究者
Annemie Spooren
Prof Dr
Hasselt University