Browsing by Author "Kroll T"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Feasibility study of the effects of art as a creative engagement intervention during stroke rehabilitation on improvement of psychosocial outcomes: Study protocol for a single blind randomized controlled trial: the ACES study
    (BioMed Central, 2014) Morris JH; Kelly C; Toma M; Kroll T; Joice S; Mead G; Donnan P; Williams B
    Background: Benefits of art participation after stroke are becoming increasingly recognized. Qualitative studies suggest that participation in visual arts creative engagement interventions (CEIs) during rehabilitation after stroke may improve mood, self-esteem, hope and some aspects of physical recovery. This study examines the feasibility of undertaking a randomized controlled trial of a CEI delivered by artists within in-patient stroke rehabilitation to test effectiveness. Methods/Design: This trial is a two arm, single-blind, randomized controlled feasibility trial within in-patient stroke rehabilitation. We will recruit 80 patients receiving stroke rehabilitation in two stroke units in a health board area of Scotland (40 patients in each arm). Intervention arm participants will receive a visual-arts based CEI facilitated by experienced artists. Artists will follow an intervention protocol with specific components that enable participants to set, achieve and review artistic goals. Participants will receive up to eight intervention sessions, four within a group and four one-to-one with the artist. Control group participants will receive usual care only. Data collection will occur at baseline, post-intervention and three-month follow-up. Stroke-related health status is the primary outcome; mood, self-esteem, self-efficacy, perceived recovery control and hope are secondary outcomes. Semi-structured interviews will be conducted with purposively selected patients, artists and healthcare staff to elicit views and experiences of the intervention and feasibility and acceptability of trial processes. Recruitment rates, retention rates and patient preference for art participation will also be collected. Data will indicate, with confidence intervals, the proportion of patients choosing or refusing participation in the CEI and will allow calculation of recruitment rates for a future definitive trial. Summary data will indicate potential variability, magnitude and direction of difference between groups. Findings will inform sample size calculations for a definitive trial. Thematic analysis of qualitative data will be managed using the Framework Approach. Framework is an analytical approach for qualitative data, commonly used in policy and medical research. Discussion: If shown to demonstrate effects, this intervention has the potential to address aspects of stroke recovery previously. Not routinely addressed in rehabilitation. Trial registration: Registered with Clinical Trials.Gov: NCT02085226 on 6th March 2014.
  • Thumbnail Image
    Item
    Physical activity participation in community dwelling stroke survivors: Synergy and dissonance between motivation and capability. A qualitative study
    (Elsevier, 2016) Morris JH; Oliver T; Kroll T; Joice SA; Willaims B
    Objectives The evidence supporting benefits of physical activity (PA) on fitness, functioning, health and secondary prevention after strokeis compelling. However, many stroke survivors remain insufficiently active. This study explored survivors’ perspectives and experiences ofPA participation to develop an explanatory framework that physiotherapists and other health professionals can use to develop person-specificstrategies for PA promotion.Design Qualitative study using semi-structured in-depth interviews. Data was audio-recorded and transcribed. Analysis followed theFramework Approach.Setting Community setting, interviews conducted within participants’ homes.Participants Community dwelling stroke survivors (n = 38) six months or more after the end of their rehabilitation, purposively selected bydisability, PA participation and socio-demographic status.Results Findings suggest that survivors’ beliefs, attitudes, and physical and social context generated synergy or dissonance between motivation(desire to be active) and capability (resources to be active) for PA participation. Dissonance occurred when motivated survivors had limitedcapability for activity, often leading to frustration. Confidence to achieve goals and determination to overcome barriers, acted as activitycatalysts when other influences were synergistic. We illustrate these relationships in a dynamic explanatory model that can be used to supportboth novel interventions and personal activity plans.Conclusions This study suggests a shift is required from purely pragmatic approaches to PA promotion towards conceptual solutions. Under-standing how synergy or dissonance between motivation and capability influence individual survivors’ behaviour will support physiotherapists and other health professionals in promoting PA. This study provides a model for developing person-centred, tailored interventions that address barriers encountered by stroke survivors.