Exploring Allied Health Professionals’ Perceptions and Practice Regarding Recommendations for Intensity of Multidisciplinary Therapy for Stroke Patients: A Qualitative Study

Background Stroke is a leading cause of death and disability in Ireland; approximately 7,500 Irish people have a stroke every year. Rehabilitation is a key aspect of stroke care; greater amounts of therapy are associated with better recovery. Data from the Irish National Office of Clinical Audit shows that stroke survivors often do not receive recommended amounts of therapy. The recently updated UK and Ireland stroke clinical guidelines now recommend larger amounts of therapy time. This qualitative study explored how allied health professionals (AHPs) feel about the recommendation, and what methods they employ in working to achieve recommended amounts of therapy. Methods This study used a qualitative research design employing semi-structured interviews to collect data. Participants were AHPs working in stroke care in Dublin, Ireland, and were recruited using a combination of purposive and snowball sampling. Interviews were audio-recorded, transcribed, and analysed using the Braun and Clarke six-step thematic analysis method. An external validator was utilised for code and theme validation. This research was approved by the Royal College of Surgeons in Ireland Research Ethics committee. Results Two main themes emerged: ‘Barriers and enablers to achieving guideline recommended therapy time’ and ‘methods of increasing therapeutic time’. Patient factors and clinical resources impact on the provision of therapy post-stroke. Overall, participants felt positive about the recent guideline recommendation for increased therapeutic time. Various methods are employed to augment patient therapeutic time, including technology and semi-supervised practice. Therapy assistants play an important role in achieving greater amounts of therapy. Conclusion AHPs see the new recommendation as challenging but are generally keen to try and achieve it, citing benefits of increased therapy time for patient outcomes. AHPs utilise a wide range of methods to optimise therapeutic time for stroke patients. The role of therapy assistants in supporting delivery of larger amounts of therapy time warrants further evaluation.