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Why do patients with stroke not receive the recommended amount of active therapy (ReAcT)? Study protocol for a multisite case study investigation.

Clarke DJ, Tyson S, Rodgers H, Drummond A, Palmer R, Prescott M, Tyrrell P, Burton L, Grenfell K, Brkic L, Forster A - BMJ Open (2015)

Bottom Line: ReAcT is designed to generate insights into the organisational, professional, social, practical and patient-related factors acting as facilitators or barriers to providing the recommended amount of therapy.Provisional recommendations will be debated in consensus meetings with stakeholders who have not participated in ReAcT case studies or interviews.Final recommendations will be disseminated to therapists, service managers, clinical guideline developers and policymakers and stroke-survivors and informal carers.

View Article: PubMed Central - PubMed

Affiliation: Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK.

No MeSH data available.


Related in: MedlinePlus

Stages in the framework approach.
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BMJOPEN2015008443F4: Stages in the framework approach.

Mentions: The multisite case studies of stroke units will be subject to within, and cross case analysis3031 to develop a robust explanation of contemporary therapy provision in these units including how staff interpret and engage with the 45 min therapy guideline. Process mapping, field notes, observational records and interviews will be transcribed and entered into the qualitative data analysis tool NVivo (V.10.0) to facilitate data management and support an iterative approach to data analysis. Data will be analysed using the Framework approach,31 which has five stages (figure 4). An iterative approach will be used to develop a plausible and coherent explanation of processes underpinning therapy provision with patients, and factors that act as barriers and facilitators to this. Analysis will also focus on understanding the perceived impact of these factors on patients’ experience of therapy. Observational, documentary and interview data will be coded; related codes will be grouped together under thematic headings that convincingly capture and explain the relationship between coded elements of text. The purpose of this element of data analysis is to contribute an overarching explanation of the contextual, organisational and professional processes evident within and across the units. This will identify and examine factors in individual unit variation as well as providing insight into factors influencing all units in terms of the 45 min therapy guidelines. The Framework approach enables development of matrices for data coded to each key theme.31 This element of the data analysis will facilitate close examination of patterns, relationships and discrepancies in the data related to the research objectives. Emerging explanations arising from the data may be explored further during fieldwork; and more examples (or contradictory ones) sought in observations of current and of subsequent units.


Why do patients with stroke not receive the recommended amount of active therapy (ReAcT)? Study protocol for a multisite case study investigation.

Clarke DJ, Tyson S, Rodgers H, Drummond A, Palmer R, Prescott M, Tyrrell P, Burton L, Grenfell K, Brkic L, Forster A - BMJ Open (2015)

Stages in the framework approach.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4550729&req=5

BMJOPEN2015008443F4: Stages in the framework approach.
Mentions: The multisite case studies of stroke units will be subject to within, and cross case analysis3031 to develop a robust explanation of contemporary therapy provision in these units including how staff interpret and engage with the 45 min therapy guideline. Process mapping, field notes, observational records and interviews will be transcribed and entered into the qualitative data analysis tool NVivo (V.10.0) to facilitate data management and support an iterative approach to data analysis. Data will be analysed using the Framework approach,31 which has five stages (figure 4). An iterative approach will be used to develop a plausible and coherent explanation of processes underpinning therapy provision with patients, and factors that act as barriers and facilitators to this. Analysis will also focus on understanding the perceived impact of these factors on patients’ experience of therapy. Observational, documentary and interview data will be coded; related codes will be grouped together under thematic headings that convincingly capture and explain the relationship between coded elements of text. The purpose of this element of data analysis is to contribute an overarching explanation of the contextual, organisational and professional processes evident within and across the units. This will identify and examine factors in individual unit variation as well as providing insight into factors influencing all units in terms of the 45 min therapy guidelines. The Framework approach enables development of matrices for data coded to each key theme.31 This element of the data analysis will facilitate close examination of patterns, relationships and discrepancies in the data related to the research objectives. Emerging explanations arising from the data may be explored further during fieldwork; and more examples (or contradictory ones) sought in observations of current and of subsequent units.

Bottom Line: ReAcT is designed to generate insights into the organisational, professional, social, practical and patient-related factors acting as facilitators or barriers to providing the recommended amount of therapy.Provisional recommendations will be debated in consensus meetings with stakeholders who have not participated in ReAcT case studies or interviews.Final recommendations will be disseminated to therapists, service managers, clinical guideline developers and policymakers and stroke-survivors and informal carers.

View Article: PubMed Central - PubMed

Affiliation: Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, UK.

No MeSH data available.


Related in: MedlinePlus