Perspectives of Stroke Survivors and Their Therapists on Effective Implementation of Strategy Training in Taiwan

Research Objectives To compare the perspectives of clients and therapists regarding the expectations for, benefits of, and factors influencing the implementation of strategy training for adults with cognitive impairment in Asian countries. Design Qualitative analysis of data collected via semi-structured interviews. Setting Rehabilitation outpatient settings. Participants Forty-six participants (mean age 55.78 years; 30 males) and their strategy training therapists (N=12) participated in semi-structured interviews. Interventions Participation-focused strategy training were provided 2 sessions per week for a total of 12 to 15 sessions, from trained therapists to the clients. Main Outcome Measures Interviews were audio recorded, transcribed verbatim, coded, and synthesized. Results Expectations, benefits and challenges toward strategy training varied between clients and therapists’ perspectives. While most of the clients did not have specific expectations before the training, the therapists expected strategy training to enhance clients’ functional abilities and participation. While the clients described that strategy training successfully enhanced their strategy planning and functional abilities, the therapists particularly acknowledged the effectiveness of strategy training for increasing clients’ self-confidence. Clients found physical impairments and therapists’ support are the strong factors influencing the training effect; therapists found clients’ personality played a substantial role in the training. Both clients and therapists agreed that family support was a key factor in the successful implementation of strategy training. Conclusions While clients and therapists had different expectations toward strategy training, both groups identified benefits of this training approach, particularly when incorporating family support. Further discussion of strategies to address factors that may influence the effectiveness of strategy training is warranted, including ways to better understand clients’ physical and psychological status, leverage encouragement, and involve family members in the training process. Author(s) Disclosures All the authors declare that no conflicts of interest exist.