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Cited by 62Stroke Rehabilitation and RecoveryMedical Practices and RehabilitationHealth Policy Implementation Science

Promoting psychosocial well-being following a stroke: Developing a theoretically and empirically sound complex intervention

Kirkevold, Marit, Bronken, Berit A., Martinsen, Randi, Kvigne, Kari·2012·International Journal of Nursing Studies
DOI 10.1016/j.ijnurstu.2011.10.006
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Abstract

Background The psychosocial consequences of stroke are complex and comprehensive and include substantial and longlasting impacts on mood, identity, social relationships, return to work and quality of life. Many studies have explored possible interventions to prevent or treat psychosocial problems, but the results have generally been disappointing. Very few studies have provided adequate theoretical accounts of the mechanisms assumed to contribute to positive outcomes.Objectives To describe the development of a psychosocial nursing intervention aimed at promoting psychosocial health and well-being and to stimulate dialogue about how to develop and report theoretically and empirically sound complex interventions in nursing.Design A systematic, stepwise approach was used, consistent with the framework recommended for developing and evaluating complex interventions by the UK Medical Research Council.Data sources Systematic reviews of empirical studies regarding the psychosocial consequences and needs of patients following stroke; qualitative, experiential studies of stroke and stroke recovery; theories of psychosocial well-being, coping, life skills, narrative approaches to rehabilitation and guided self-determination.Review methods Each systematic review was examined to determine the major psychosocial challenges and needs experienced by stroke survivors, focusing on how these challenges and needs developed over the illness trajectory, how previous interventions had sought to address them and the effective mechanisms assumed to affect the level of success of interventions. Qualitative studies were examined to reveal the subjective experiences of stroke and stroke recovery, paying particular attention to the development of needs across time and context. A qualitative synthesis of the major characteristics of the trajectory of stroke rehabilitation and recovery during the first year was developed. Theories were examined to illuminate possible effective mechanisms and actions aimed at promoting psychosocial well-being during the stroke recovery process.Results A dialogue-based intervention comprising eight encounters between stroke survivors and trained health care workers was designed, based on narrative theories, empowerment philosophy and guided self determination. Worksheets and a guiding topical outline were developed to support the dialogue.Conclusions The UK Medical Research Council framework facilitated the systematic development of an empirically and theoretically informed complex nursing intervention aimed at promoting post-stroke psychosocial well-being.

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  • 17 of the 27 included studies used the MRC 2000 framework, the updated 2008 version, or a combination of the two.

    “In particular, 17 of the 27 studies included in this review used the MRC 2000 framework, the updated 2008 version or a combination of the two [24–40].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [31]

  • Interventions were delivered in a variety of settings (e.g. inpatient, outpatient clinics and home-based settings) and targeted a wide range of conditions, such as mental health conditions, stroke, cancer and other chronic illnesses.

    “Interventions were delivered in a variety of settings (e.g. inpatient, outpatient clinics and home-based settings) and targeted a wide range of conditions, such as mental health conditions [28, 30, 35, 40, 47], stroke [31, 36, 39], cancer [29, 32, 33, 37, 42] and other chronic illnesses [25, 34, 38].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [31]

  • Fourteen included studies explored the acceptability and/or feasibility of the intervention to different stakeholders, including providers, recipients or policy makers and service commissioners.

    “Fourteen studies explored the acceptability and/or feasibility of the intervention to different stakeholders, including providers, recipients or policy makers and service commissioners [27, 29–32, 34, 36, 37, 39, 40, 42, 43, 47, 48].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [31]

  • Several included studies employed well-established qualitative methods including interviews or focus groups with providers and recipients or relevant stakeholders, and observations and consensus processes including researchers, patients and clinical experts.

    “Several studies employed well-established qualitative methods including interviews or focus groups with providers and recipients or relevant stakeholders [26, 30, 32, 34, 39, 47, 48] and observations and consensus processes including researchers, patients and clinical experts [31].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [31]

  • The majority of included studies (n = 16) subsequently refined the intervention to then test the optimised version within pilot studies or full-scale RCTs.

    “The majority of studies (n = 16) subsequently refined the intervention to then test the optimised version of the intervention within pilot studies or full-scale RCTs [24–32, 34, 38–40, 43, 47, 48].”

    From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [31]

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Authors
Kirkevold, M., Bronken, B. A., Martinsen, R., & Kvigne, K.
Affiliations
  • University of Oslo (NO)
  • Hedmark University College (NO)
Corresponding author
Kirkevold, Marit
ORCID
Venue
International Journal of Nursing Studies
Publisher
Elsevier BV
Published
2012-04
Volume
49
Issue
4
Pages
386-397
ISSN
0020-7489 (ISSN-L)
DOI
10.1016/j.ijnurstu.2011.10.006
OpenAlex
W2071878128
Cited by
62
References
87
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 7 · 2016: 3 · 2015: 8 · 2014: 3 · 2013: 6 · 2012: 3
FWCI
3.89
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • International Journal of Nursing Studies (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • EkstraStiftelsen Helse og Rehabilitering (Stiftelsen Dam)
  • Høgskolen i Hedmark
  • Universitetet i Oslo
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
stroke, psychosocial well-being, complex intervention development, nursing interventions, stroke rehabilitation, stroke recovery, guided self-determination, empowerment, coping, life skills, intervention mechanisms, MRC framework for complex interventions, interpersonal relationships, return to work, quality of life
MeSH terms
Humans, Needs Assessment, Stroke, Empirical Research

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