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Nominal group technique to establish the core components of home-based rehabilitation for survivors of stroke with severe disability
Lee, Claire
Lee, Claire
Abstract
In the UK, over 20% of patients leaving hospital after a stroke will be severely disabled. Despite this, limited clinical guidance is available to teams tasked with providing support for this complex population at home. Additionally, many areas across the UK are not commissioned to treat this patient cohort, leaving them with no specialist support on discharge.Objectives To establish core components of home-based rehabilitation for survivors of stroke with severe disability, based on expert panel consensus.Setting Virtual nominal group technique (vNGT) across the UK.Participants Experts in the field of stroke rehabilitation (n=14) including researchers, clinicians and those with lived experience.Methods Two vNGT were completed using a freely available online platform, Microsoft Teams. The technique’s five stages were completed virtually; introduction, silent idea generation, round robin, clarifications and scoring. Statements were analysed for consensus, those achieving consensus underwent content analysis to form rich overarching consensus statements.Results A combined total of 421 statements achieved positive consensus (>75% in agreement), which formed 11 overarching consensus statements. These outline key components of home-based rehabilitation for survivors of stroke with severe disability including the structure and members of the team, as well as the skills and knowledge required.Conclusion The consensus statements highlight the complexity of managing patients with severe stroke disability following discharge from hospital. This study has the potential to support the provision of services for this patient group, providing a benchmark for commissioners and clinicians as well as setting expectations for stroke survivors and their carers. What remains unknown is how many services currently offer this service to patients with severe disability.Data are available on reasonable request.
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Date
2021
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Article
Subject
Stroke, Rehabilitation, Home care services
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Citation
Fisher, R. J., Riley-Bennett, F., Russell, L., Lee, C., Sturt, R., Walker, M. & Sackley, C. (2021). Nominal group technique to establish the core components of home-based rehabilitation for survivors of stroke with severe disability. BMJ Open, 11(12), pp.e052593.
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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
