Edinburgh Napier University

  Introduction: Visual impairment (VI) affects 30-60% of stroke survivors and reduces quality of life. Knowledge of long-term needs is limited, and service provision is highly variable. Self-management is recommended in stroke guidelines, but interventions can lack a basis in stakeholder needs and experiences. This study aimed to co-design a theory and evidence-based intervention tailored to the unmet needs of stroke survivors with VI.
Method: Intervention Mapping was used, informed by previous systematic reviews and qualitative evidence. Steps 1-4 of this iterative design process were conducted with key stakeholders (n=14; stroke survivors, health professionals, academics) across five two-hour focus groups. Step 1 identified priority unmet needs. Step 2 explored the factors that cause these needs to remain unaddressed. Step 3 used Social Cognitive Theory to inform the selection of appropriate, evidence-based intervention components. Step 4 designed the intervention using the TiDieR template.
Results: The new VISUALISE self-management intervention addresses four key unmet needs (i)education, (ii)practical support, (iii)peer and emotional support and (iv)confidence. VISUALISE procedures include group sessions incorporating goal-setting, reflection and peer support. Workbook materials cover intervention content, community resources and support and include a diary to document and reflect on progress. It is provided by peer-leader and healthcare professionals in-person, in nine weekly two-hour sessions. VISUALISE is tailored to individual participants’ personal goals and education needs. An accompanying peer network will provide longer-term support.
Conclusion: Intervention Mapping supported the development of VISUALISE, an evidence and theory-based self-management intervention tailored to the priority unmet needs of stroke survivors with VI.