title: Engaging service users in the development of stroke services: an action research study.
abstract: OBJECTIVE
  To develop local stroke services by involving, in a meaningful way, those affected by stroke in identifying and prioritising service development issues.
  
  
  BACKGROUND
  Consideration should be given to including the views of service users in the evaluation and re-design of services. In stroke, the involvement of patients and carers in the development of services has generally been at a consultative level. There is a need to explore strategies to engage patients and carers more fully with the service development agenda.
  
  
  METHODS
  Action research.
  
  
  METHODS
  Within the Reflection Phase of this action research study patients' and carers' experiences of stroke services were explored by semi-structured interviews and focus groups. In the Planning and Action Phases, externally facilitated workgroups comprising patients, carers and professionals used a synthesis of the data to identify a range of service development priorities, which informed the development of action plans.
  
  
  RESULTS
  Information provision, preparation for transfer of care and the integration of social and leisure activities appear to be priorities for the development of stroke services from the perspective of patients and carers. These findings informed the work of four collaborative workgroups to lead developments in the stroke pathway as follows: stroke prevention and immediate care, early and continuing rehabilitation, transfer of care and long-term support and information provision.
  
  
  CONCLUSIONS
  Stroke patients and carers played a key and meaningful part in the identification and prioritisation of service development issues. External facilitation ensured progress with service development and maintaining patient and carer participation. Several pragmatic recommendations for enhancing the local delivery of stroke services were made.
  
  
  CONCLUSIONS
  With external facilitation it is possible for stroke service users to take a meaningful role in service developments that moves beyond consultation.
authors.affiliation: Clinical Practice Research Unit, Department of Nursing, University of Central Lancashire, Preston, UK. sjones10@uclan.ac.uk
authors.forename: Stephanie P
authors.initials: SP
authors.lastname: Jones
authors.forename: Malcolm F
authors.initials: MF
authors.lastname: Auton
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Burton
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Watkins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D016730:Program Development; D020521:Stroke / Q000451:nursing / Q000628:therapy*; D006113:United Kingdom