Our research

The IMPlementing supported sElf-managemenT in Stroke (IMPETUS) Study

What is our research about?

What’s the background to our study?
‘Supported self-management’ is a term used to describe the type of help and support that staff in community rehabilitation services offer to people when they’ve been discharged from hospital.  

The idea of ‘supported self-management’ is to:

  • help people to ‘get on with life’,
  • help them to feel in control and confident to look after themselves well, and
  • feel able to manage any lasting effects of their stroke.  

Research shows that support to help people to self-manage can be beneficial for stroke survivors and their families, but the type and standard of support available vary across the UK.  

What’s the aim of our study?
We want to know what kinds of support work well and what doesn’t work well in local areas for helping people who have had a stroke to self-manage. Our patient and public involvement team tell us about the aims of the project here.

What methods will we use?
We will speak to people in four regions of Scotland:

  • stroke survivors
  • health professionals and
  • managers from community rehabilitation services

We will focus on Scotland to gather the initial information, then we will also look at how the findings apply to other parts of the UK.

What outcomes do we expect from the study?
This study will:

  • Help to understand what is important in making supported self-management work well from different viewpoints, including the viewpoints of stroke. survivors, community health professionals and service managers
  • Help to ensure that regardless of where people live, they are offered the same high standard of support to help them to self-manage so they can enjoy a good quality of life and feel confident to look after themselves well in the longer-term after their stroke.
  • Tell us more about what further research is needed to help people to self-manage well after a stroke.

What do we mean by self-management?

  • The decisions and actions that people take to look after themselves well, to feel in control over their lives, and to cope with any lasting effects that they experience after having a stroke.

What do we mean by supported self-management?

  • The help and support that health and social care professionals offer to help people to develop the skills and confidence to be in control of their self-management.
  • A person-centred approach to supporting people to feel genuinely in control over their lives and able to live well after a stroke.

Supported self-management isn’t about replacing services or expecting people to do everything for themselves.

Our research methods in more detail

Our qualitative study is underpinned by Realist Evaluation (RE). Realist evaluation aims to understand what works for whom in what context and why. RE will be used in this study to describe how supported self-management in stroke is delivered across different geographical settings and by different people and community-based teams. Find out more about realist evaluation here and here.

To find out more about supported self-management, the backstory to the project, and what we plan to achieve with IMPETUS, see here.

Our study will be undertaken in three workpackages:

impetus logo

1. Realist review

We will systematically explore the literature about supported self-management using a type of literature search and synthesis called a realist review. The purpose of a realist review is to find out what situations or environments (context) supported self-management work in, the mechanisms by which it works in these contexts, and the outcomes of this.

Read more about our realist review on PROSPERO.

2. Q-methodology study

We will explore people’s views on what is important in supported self-management using Q methodology. Q methodology is a mixed method research approach combining qualitative (textual, non-numerical data) and quantitative (numerical data) techniques to study people’s own opinions or beliefs. This method allow us to identify and describe the shared viewpoints that exist on supported self-management following stroke. This will reveal areas of agreement and disagreement which can be used to develop ideas about what makes supported self-management work. The results of the Q methodology study will be used to inform the questions asked in the third workpackage.

  • To learn more about Q methodology watch this short video from Leeds University.

3. Qualitative interviews and focus groups

The interviews and focus groups will describe how supported self-management is delivered and ‘works’ in different settings of community-based stroke rehabilitation. We will explore the perspectives of stroke survivors, multidisciplinary professionals working in community stroke teams, and senior managers in each of the four Scottish sites.

Once we have finished these three workpackages we will aim to share these findings with people who have had a stroke and people working in the field of stroke care, policy and research to help identify practical recommendations from the research.