About Bridges
Recognising a disparity between care at the ‘front end’ of stroke and support in the longer term we have developed and piloted a new individualised stroke self-management programme.
Bridges is a programme developed in consultation with stroke survivors, and informed by a multiprofessional group of experts in stroke and self-management.
It is based on current best clinical evidence in stroke, empirical self-management research for long term conditions and underpinned by social cognition theory and self-efficacy principals (Bandura, 1997). The Bridges Stroke programme comprises two main features:
1. Accredited Workshops and Support for stroke practitioners to enable the learning of effective skills, theory and research relevant to stroke self-management, allowing the use of the Bridges Stroke approach via a series of one to one self-management sessions with the stroke survivor.
2. The provision of personalised, interactive, stroke workbooks given to practitioners to work with the stroke survivor to support their self-management. The stroke workbook comprises of individual stories and strategies suggested by stroke survivors, together with a diary section to record personal targets and successes.
The Bridges Stroke programme was initially piloted during 2007in three sites; Inverness, London, and Dorset. Feedback via focus groups at these sites enabled further developments to the training and the stroke workbook. We have since worked closely with Connect (a national charity for people with stroke and aphasia) and a number of modifications were made to the stroke workbook following an evaluation event held early in 2008 with a group of people with Aphasia.
The first Bridges Stroke workshops were held for stroke teams based in London, Dundee and Cardiff in 2008. Overall attendees felt Bridges Stroke training enhanced their practice by giving more control to stroke survivors, enabling them to move away from traditional professional/patient relationships, which can stifle the development of self-management skills.
We recognise that Bridges Stroke is a programme which will not suit everyone, and more empirical research is needed. A first stage in the process of testing feasibility and acceptability has now commenced in Belfast with a pilot randomised controlled trial.
We will also be carrying out focus groups with stroke survivors and carers about their experiences of using the Bridges Stroke programme.
In addition we have launched an interactive discussion forum for workshops attendees to feedback on their experiences of using the stroke workbook with individuals on their caseload and training.
Practitioners also contribute to the development of the programme by completing case reflections which are reviewed and discussed at follow-up workshops