Nominal group technique to establish the core components of home-based rehabilitation for survivors of stroke with severe disability

Fisher, Rebecca J; Riley-Bennett, Frances; Russell, Lal; Lee, Claire; Sturt, Ruth; Walker, Marion; Sackley, Cath

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 voting. 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 and the skills and knowledge required within the UK NHS.

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.

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), Article e052593. https://doi.org/10.1136/bmjopen-2021-052593

• Journal Article Type: Article
• Acceptance Date: Oct 29, 2021
• Online Publication Date: Dec 2, 2021
• Publication Date: 2021-12
• Deposit Date: Nov 4, 2021
• Publicly Available Date: Dec 2, 2021
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 12
• Article Number: e052593
• DOI: https://doi.org/10.1136/bmjopen-2021-052593
• Public URL: https://nottingham-repository.worktribe.com/output/6610740
• Publisher URL: https://bmjopen.bmj.com/content/11/12/e052593.abstract