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Cited by 58Nursing care and researchStroke Rehabilitation and RecoveryFamily Caregiving in Mental Illness

Caring for carers of people with stroke: developing a complex intervention following the Medical Research Council framework

Robinson, Louise, Francis, Jill, James, Peter, Tindle, Norma, Greenwell, Kim, Rodgers, Helen·2005·Clinical Rehabilitation
DOI 10.1191/0269215505cr787oa
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Abstract

Objective: To develop an intervention, using the first three phases of the Medical Research Council (MRC) framework for complex interventions, to facilitate coping skills in new carers of stroke patients. Methods: In the preclinical (theoretical) phase, a theoretically based framework for a small group course for carers of people with stroke was developed. The intervention was grounded in a cognitive behavioural model and included carers' needs identified from a literature review. Phase I (modelling phase) comprised a qualitative study involving one-to-one semi-structured interviews with a purposive sample of informal carers of people with stroke. Following this, the intervention was modified. In phase II (exploratory phase), the modified intervention was delivered by a clinical psychologist and stroke nurse practitioner to five carers. Following postcourse interviews the course was further refined and delivered to seven new carers who subsequently completed a satisfaction questionnaire. Results: Carers' needs identified from the literature included information provision; managing emotions; social support; health maintenance; and practical problem solving. Consultation with existing carers confirmed these as important issues with a strong emphasis on finding niches of control in life, becoming an expert carer, and dealing with emotional upheaval. Participants reported feeling more optimistic and empowered subsequent to the course. Conclusions: The MRC framework provided a useful methodology for the development of a complex intervention. The course aimed to assist carers to regain control over aspects of their lives and manage their emotions. It was feasible to run and acceptable to carers; however a randomized controlled trial (RCT) is required to evaluate its effectiveness.

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  • 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 [39]

  • 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 [39]

  • 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 [39]

  • Optimisation strategies applying qualitative methods tended to explore acceptability and feasibility issues.

    “Optimisation strategies applying qualitative methods tended to explore acceptability and feasibility issues [26, 30, 32, 34, 39, 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 [39]

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Authors
Robinson, L., Francis, J., James, P., Tindle, N., Greenwell, K., & Rodgers, H.
Affiliations
  • Newcastle University (GB)
  • North Tyneside General Hospital (GB)
ORCID
Venue
Clinical Rehabilitation
Publisher
SAGE Publications
Published
2005-08
Volume
19
Issue
5
Pages
560-571
ISSN
  • 0269-2155 (ISSN-L)
  • 1477-0873
DOI
10.1191/0269215505cr787oa
OpenAlex
W2147848642
Cited by
58
References
45
Citations by year
2025: 3 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 4 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 4 · 2012: 3
FWCI
13.62
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Clinical Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Funders
Stroke Association
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
stroke, informal caregivers, caregiver coping, complex intervention development, MRC framework, cognitive-behavioral model, caregiver needs, emotional management, social support, empowerment, intervention feasibility and acceptability
MeSH terms
Adaptation, Psychological, Adult, Aged, Emotions, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Social Support, Stress, Psychological, Caregivers, Stroke

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