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Interested in finding out more about Bridges?

 

PRACTITIONERS click here for detailed FAQ's or click here for the evidence supporting the programme

 

COMMISSIONERS and TRAINING MANAGERS please click here

 

PATIENTS/CARERS click here

 

RESEARCHERS/COLLABORATORS/GENERAL ENQUIRIES please register your interest here...

 

 

Bridges Open Workshops

 

We run open workshops for individual practitioners working in neurological and general rehabilitation, or perhaps you work with stroke survivors in the voluntary or third sector.   

 

Click here for more information about our open workshops

 

 

 

 

Belfast Study

Background

A pilot randomised controlled trial testing Bridges was undertaken in Belfast, from 2009 to 2010.

The study was led by Dr Sheila Lennon (previously of University of Ulster, now based in Flinders University Adelaide), and was funded by the Northern Ireland Chest Heart and Stroke Association.

The trial explored the feasibility of using the “Bridges” programme to enhance self-management skills for stroke survivors in conjunction with ongoing rehabilitation delivered by a community stroke team (CST) over a six week intervention period.

Methods

Participants were recruited through the community stroke team of the South Eastern Health and Social Care Trust (SEHSCT) in Northern Ireland, and were randomised either to a control or a Bridges group over a 13 month period.

The “Bridges” intervention consisted of using a self-directed but professionally supported workbook to directly focus on enhancing self efficacy (Jones et al, 2009) in order to improve patients’ self management skills. Participants allocated to the control group continued with routine multidisciplinary team (MDT) care and usual activities. The two primary outcomes were health related Quality of Life (Stroke Specific Quality of Life-SSQOL & Euroquol) and self-efficacy (SE: Stroke Self-Efficacy Questionnaire-SSEQ & the Self-Efficacy Scale-SES). Secondary outcomes were activity, mood, and community integration.

Results

Results from the study show that the Bridges stroke self-management programme impacted on the self-efficacy in stroke survivors who used it. The self-efficacy of stroke survivors in both the control and the intervention groups had improved after the study period was over, but there was a greater change in the group who used the Bridges programme .

Key findings from the qualitative interviews with stroke survivors and practitioners were as follows:

The Stroke Survivor perspective:

•       Bridges facilitates peer learning, encourages goal setting and helps participants manage their progress.

•       The professionals were able to “guide” participants through the intervention process and help assess their progress. 

•       The process of goal setting and reflection was most important.

•      Participants would continue to use their workbook in the future and refer to it, to see how far they have come.

The Professionals perspective:

•       “Bridges” had the most impact for patients who engaged well in the goal setting aspect of the intervention.

•       External influences may influence the impact of “Bridges”, in particular family/carer influence.

•       Particular skills such as listening, problem solving etc are more important than a particular professional group when determining who should deliver the “Bridges” SMP.

•      “Bridges” provided the professionals with a “structure” which was different from their usual practice, as it was a planned way of focusing on the patients goals.

Conclusions

Overall the study demonstrated that it is feasible and acceptable to deliver the Bridges programme in post hospital stroke rehabilitation. The Bridges intervention promotes a structure for involving stroke survivors in their rehabilitation by enabling self-management practices and, encourages a greater consistency in using a self-management approach between professionals working in the same community stroke team. These findings support the further investigation of the additional benefits of building self management programmes into community rehabilitation for stroke survivors.

This was the only research to have explored the delivery of an individualised stroke specific self-management intervention in a UK community rehabilitation setting. Dissemination of these research findings has already informed the practice of providers of self-management interventions for individuals with stroke. Refinements of the training procedures and the qualitative findings have been integrated into the further development of the Bridges programme, and the certification process for Bridges workshops across the UK. The findings from this study have informed the design of two further studies to explore self-management interventions for stroke survivors in the community. 

Papers are currently being prepared for publication

Presentations given about the Belfast study

McKenna S, Lennon S, Glenfield P, Jones F. May 2012, World Congress for NeuroRehabilitation. “Bridges” – Promoting self-management for stroke survivors in the community: A feasibility randomised controlled trial. Poster Presentation

McKenna S, Jones F, Glenfield P, Lennon S.  June 2011, Nov/Dec 2001 UK Stroke Forum. “Bridges” – Promoting self-management for stroke survivors in the community: A feasibility randomised controlled trial. Poster Presentation

McKenna S, Lennon S, Glenfield P, Gardner E, Jones F. Oct 2001, Northern Ireland Multidisciplinary Association for Stroke Teams (NIMAST) Conference. “Bridges” – Promoting self-management for stroke survivors in the community: A feasibility randomised controlled trial. Oral Presentation

McKenna S, Lennon S, Crosbie J, Glenfield P, Jones F. June 2011, World Confederation for Physical Therapy Congress. “Bridges” – Promoting self-management for stroke survivors in the community: A feasibility randomised controlled trial. Poster Presentation

McKenna  S, Jones F, Glenfield P, Crosbie J, Lennon S. Nov/Dec 2010, UK Stroke Forum. Bridges stroke self-management for stroke survivors in the community: The patient and stroke team perspectives. Poster Presentation

McKenna  S, Jones F, Glenfield P, Crosbie J, Lennon S. May 2010, Rehabilitation and Therapy Research Society (RTRS) Conference. Stepping Out: Promoting self-management for stroke survivors in the community. A Feasibility Study. Poster Presentation

Gillespie S, Lennon S, McKenna S, Crosbie J, Glenfield P, Jones F. May 2010, European Stroke Conference. Bridges self management for stroke survivors in the community: an ongoing feasibility RCT. Poster Presentation

Orr R. Nov 2009, NIMAST Life After Stroke Conference. Stepping Out-a stroke self-management programme. Oral Presentation

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