title: Process evaluation of the Restore4stroke Self-Management intervention 'Plan Ahead!': a stroke-specific self-management intervention.
abstract: OBJECTIVE
  To investigate whether the self-management intervention was implemented as intended. Additionally, we studied involvement in and satisfaction with the intervention among patients, their partners and therapists.
  
  
  METHODS
  Mixed method, prospective study.
  
  
  METHODS
  Outpatient facilities of hospitals/rehabilitation centres.
  
  
  METHODS
  Stroke patients, their partners and therapists from the experimental arm of the Restore4Stroke Self-Management study.
  
  
  METHODS
  'Plan Ahead!' is a 10-week self-management intervention for stroke patients and partners, consisting of seven two-hour group sessions. Proactive action planning, education and peer support are main elements of this intervention.
  
  
  METHODS
  Session logs, questionnaires for therapists, patients and their partners, and focus groups.
  
  
  METHODS
  Qualitative data were analysed with thematic analysis supplemented by quasi-statistics. Quantitative data were reported as descriptive statistics.
  
  
  RESULTS
  The study sample consisted of 53 patients and 26 partners taking part in the intervention, and all therapists delivering the intervention (N = 19). At least three-quarters of the intervention sessions were attended by 33 patients and 24 partners. On a scale from 1 to 10, patients, partners and therapists rated the intervention with mean scores of 7.5 (SD1.6), 7.8 (SD.7) and 7.4 (SD.7), respectively. Peer support was the most frequently appreciated element for participants and therapists. The proactive action planning tool was adequately applied in 76 of the 96 sessions.
  
  
  CONCLUSIONS
  Although the target audience was reached and both participants and therapists were satisfied with the intervention, the proactive action planning tool that distinguishes the current intervention from existing stroke-specific self-management interventions was only partly implemented according to protocol.
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.|Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Nienke S
authors.initials: NS
authors.lastname: Tielemans
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Vera Pm
authors.initials: VP
authors.lastname: Schepers
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Johanna Ma
authors.initials: JM
authors.lastname: Visser-Meily
authors.affiliation: Department of Health Services Research and CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jolanda Cm
authors.initials: JC
authors.lastname: van Haastregt
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Wendy Jm
authors.initials: WJ
authors.lastname: van Veen
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.|Experimental Psychology, Helmholtz Institute/Utrecht University, Utrecht, The Netherlands.
authors.forename: Haike E
authors.initials: HE
authors.lastname: van Stralen
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands c.vanheugten@maastrichtuniversity.nl.|Faculty of Psychology and Neurosciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D012648:Self Care; D012944:Social Support; D020521:Stroke / Q000628:therapy*
keywords: Implementation; mixed methods; participants; process evaluation; self- management; therapists