Feasibility of a mental practice intervention in stroke patients in nursing homes; a process evaluation
1 Research Centre for Autonomy and Participation of Persons with a Chronic Disease, Department of Health and Technique, Zuyd University of Applied Sciences, Heerlen, The Netherlands
2 Centre of Expertise in Life Sciences, Zuyd University of Applied Sciences, Heerlen, The Netherlands
3 CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
4 Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
5 Klevarie Nursing Home, Vivre foundation, Maastricht, The Netherlands
6 Department of Health and Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
7 Department of Rehabilitation, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
8 Oxford Centre for Enablement, Oxford, Great-Britain
9 Department of General Practice, Faculty of Health, Medicine and Life Sciences Maastricht University, Maastricht, The Netherlands
BMC Neurology 2010, 10:74 doi:10.1186/1471-2377-10-74Published: 24 August 2010
Within a multi-centre randomised controlled trial in three nursing homes, a process evaluation of a mental practice intervention was conducted. The main aims were to determine if the intervention was performed according to the framework and to describe the therapists' and participants' experiences with and opinions on the intervention.
The six week mental practice intervention was given by physiotherapists and occupational therapists in the rehabilitation teams and consisted of four phases: explanation of imagery, teaching patients how to use imagery, using imagery as part of therapy, and facilitating the patient in using it alone and for new tasks. It had a mandatory and an optional part. Data were collected by means of registration forms, pre structured patient files, patient logs and self-administered questionnaires.
A total of 14 therapists and 18 patients with stroke in the sub acute phase of recovery were involved. Response rates differed per assessment (range 57-93%). Two patients dropped out of the study (total n = 16). The mandatory part of the intervention was given to 11 of 16 patients: 13 received the prescribed amount of mental practice and 12 practiced unguided outside of therapy. The facilitating techniques of the optional part of the framework were partly used. Therapists were moderately positive about the use of imagery in this specific sample. Although it was more difficult for some patients to generate images than others, all patients were positive about the intervention and reported perceived short term benefits from mental practice.
The intervention was less feasible than we hoped. Implementing a complex therapy delivered by existing multi-professional teams to a vulnerable population with a complex pathology poses many challenges.