Translating Knowledge and Evaluating Impactful Resources
Research type
Research Study
Full title
Translating knowledge and evaluating impactful resources to promote self-management, health and well-being to individuals following an amputation.
IRAS ID
249701
Contact name
Fiona Leggat
Contact email
Sponsor organisation
St Mary's University
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Summary of Research
The primary aim of the research is to create a set of resources which translate knowledge to both individuals who have undergone a lower limb amputation and rehabilitation staff who work with such patients. These resources will contain knowledge which has been collected in a past PhD project which aimed to build the understanding of amputee patients’ psychological and social needs during their recovery. The patient resources will be targeted at the post-hospital discharge phase of rehabilitation, whereby patients have left the hospital and are transitioning back into everyday life. The role of physical activity and self-management knowledge will also be encompassed into the patient resources, with the aim to improve their wellbeing. We will also use the previously knowledge gathered to create resources for staff, about how they can best meet patients’ needs to enhance the recovery process within their early hospital rehabilitation.
The secondary aim of the research is to monitor and evaluate the effectiveness and usefulness of the resources for the patients and staff. This will be done over a longitudinal period. This research is being conducted in the Douglas Bader Rehabilitation Centre at Queen Mary’s Hospital, Roehampton. It is funded jointly by Queen Mary’s Hospital and St Mary’s University, Twickenham. The research will last for up to three years in total, and each individual will participate for up to one year. Staff working at the centre and patients entering the rehabilitation programme will be given the opportunity to take part. Participants may choose to take part in up to seven different research activities: interviews, observations, journal/diaries, focus groups, surveys, photo voice and time lining. All research activities for rehabilitation staff and patients attending the hospital may be completed during normal working hours, whilst post-discharge patients’ research activities will take place at a time and location of their choosing.Summary of Results
To address the first aim, to co-construct narrative knowledge into formats to be translated into practice, rehabilitation therapists’ (RTs) and established prosthetic users (EPUs) perceptions of the narrative knowledge, and barriers and facilitators likely to influence use of such knowledge in practice, were explored. Such perceptions were obtained iteratively as the co-construction processes (e.g., co-design, co-editing) ensued. Overall, RTs engaged in collaboration activities to co-construct the materials for new RTs, while five EPUs and thirteen RTs engaged in differing collaboration activities to co-construct the materials for individuals with major lower limb amputation (MLLA). Data from collaboration activities was analysed using abductive content analyses. Perceptions of the narrative knowledge, and the possible translation of the knowledge yielded three themes from therapists and four themes from EPUs: 1) New RTs should know the narratives, 2) the narratives can be seen in practice, and 3) shaping useful and tangible narrative knowledge, and 1) narrative authenticity, 2) emotional stimulation, 4) narrative modifications, and 4) learning opportunities, respectively. Both collaborating populations perceived the narratives to be authentic, and beneficial to address the limited narrative environment given the potential learning opportunities. However, for the narratives to have practical value for new RTs and inform patient care behaviours, further knowledge, in the form of guidance strategies was deemed necessary. Apprehension was also expressed surrounding the sharing of the narratives of illusory cure and projection with individuals with MLLA. Such cautiousness was attributed to the lack of hope illustrated.
Findings also yielded likely barriers and facilitators to narrative knowledge use which resembled eight Theoretical Domains Framework (TDF) v2 categories. These categories included knowledge, beliefs about capabilities, beliefs about consequences, intentions, memory, attention, and decision processes, emotion, environmental context and resources, and social influence. The findings informed the co-design of the narrative knowledge formats, and co-construction of additional components to enhance knowledge uptake.To address the second aim, to evaluate the use of the narrative knowledge formats in practice, experiences of new RTs and individuals in MLLA rehabilitation were explored. Semi structured interviews were conducted with six new RTs, and data was analysed using a reflexive thematic analysis. The thematic analysis yielded five themes: juggling narratives with competing contextual demands, longitudinal narratives vs short-term patient stays, navigating challenges with narratives, the awareness-raising capacity of narratives, and narratives can inform professional practice.
Qualitative surveys and group discussion data were used to gather data about the narrative resources from 17 people in MLLA rehabilitation. Data was analysed using a reflexive thematic analysis. Four themes were developed during the
analysis: narratives connect, narratives teach, narratives start conversations, and narratives act. Findings demonstrated that individuals found the narrative knowledge to be authentic, prompting connectivity with characters in the narrative videos developed. The narrative videos elicited a plethora of reactions, and provided individuals with an understanding of what to expect in rehabilitation and life after. Individuals with MLLA recognised that everyone’s journey may be different, and appreciated that good days and bad days can occur. Such learning prompted feelings of validation, reassurance, and a reduction in stigmatisation. Individuals further described intentions to act upon observed behaviours from the narrative videos to finish rehabilitation and manage their transition into everyday life.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
18/WM/0279
Date of REC Opinion
21 Sep 2018
REC opinion
Further Information Favourable Opinion