- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06065397
Goal-setting in Stroke: From Guideline Towards Implementation: a Realist Evaluation
Overall objective: The aim of the project is to integrate the quality improvement programme on goal setting into the current care of people with stroke and to test and refine this programme.
Target group:
- People after a stroke (treatment in the participating centres); total number 155 people
- Informal carers (only if the person has had a stroke and has limited opportunities to participate)
- Professional carer; total number 155 people
What?
The goal-setting programme becomes standard care, it is checked whether the programme has been applied in care by health professionals (review of the patient's medical record), what the effects are on patients (questionnaires) and health professionals (questionnaires) and whether the quality improvement programme needs to be adjusted or refined (interviews with health professionals and the patient group)
When to evaluate?
- Health professionals: start of the study and end of the study via questionnaires. Interviews/focus group (every 3 months)
- Review of patient records and observations (every 3 weeks)
- Patient assessment: Admission and 1 week before discharge or end of study, Interviews/focus group (3 months)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Aim This study aims to evaluate the implementation of a quality improvement program to improve goal-setting in the rehabilitation process after a stroke event (further referred to as goal-setting programme) by means of a realist evaluation.
During this project, following questions will be answered:
What are the different elements and the final form of the initial goal-setting programme? How is goal-setting for the implementation of the goal-setting programme conducted? How is the goal-setting programme implemented? Is the goal-setting programme accepted, is it appropriate and feasible to implement? (review the implementation process).
Are adjustments needed on the goal-setting programme? How are the adjustments in the goal-setting programme being followed up? (review the implementation process) Does the implementation of the goal-setting programme in healthcare have an effect for patient or professional healthcare providers? (patient and healthcare professional outcome: Satisfaction with stroke care, participation, emotional status, empowerment and quality of life and overall feeling on goal-setting in stroke care)
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Annemie Spooren, prof dr
- Phone Number: +3211269332
- Email: annemie.spooren@uhasselt.be
Study Locations
-
-
Limburg
-
Hasselt, Limburg, Belgium, 3500
- Recruiting
- UHasselt
-
Contact:
- Liselot Thijs, Phd
- Phone Number: 003222862653
- Email: liselot.thijs@uhasselt.be
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Professional healthcare providers
Inclusion criteria:
- Participants are employed in hospitals, rehabilitation centres and/or private practices/primary healthcare facilities located in the provinces: Province of Flemish Brabant, Brussels, Province of Walloon Brabant, Limburg
- Participants have a social, medical profession/background, work in the management of healthcare services or quality of healthcare
- Participants involved (direct or indirect) in the goal-setting process of the patients
- Participants who master the Flemish or French language
- Adult participants (≥18 years)
Exclusion criteria:
• Not giving informed consent
Patients
Inclusion criteria:
- Participants after a stroke event.
- Residence in one of the four participating sites, in outpatient care or receive treatment in first line zone
- Participants who master the Flemish or French language
- Adult participants (≥18 years)
Exclusion criteria:
- Not giving informed consent
- Other severe comorbidities that interfere with the rehabilitation process or goal-setting process
Informal caregivers
Inclusion criteria:
• Informal caregiver of a stroke patient admitted to one of the four participating sites
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: People after a stroke event
Implementation of improvement program
|
A improvement program how to optimalize patient-centered goal setting in rehab care is being implemented.
|
Experimental: Healthcare professionals
Implementation of improvement program
|
A improvement program how to optimalize patient-centered goal setting in rehab care is being implemented.
|
Experimental: Close relatives of people after a stroke
Implementation of improvement program
|
A improvement program how to optimalize patient-centered goal setting in rehab care is being implemented.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adoption and adherence of goal-setting programme- in acute care setting
Time Frame: Once up to 3 weeks during the hospitalisation period, through study completion, an average of 1 year
|
The medical record screens whether all points of the predetermined goal setting programme are carried out and noted in the medical record.
|
Once up to 3 weeks during the hospitalisation period, through study completion, an average of 1 year
|
Adoption and adherence of goal-setting programme- in rehabilitation setting
Time Frame: Every 3 weeks during the hospitalisation period, through study completion, an average of 1 year
|
The medical record screens whether all points of the predetermined goal setting programme are carried out and noted in the medical record.
|
Every 3 weeks during the hospitalisation period, through study completion, an average of 1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of patient/ informal caregivers: Measuring patient satisfaction with stroke care
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Measuring patient satisfaction with stroke care: Satisfaction with stroke care questionnaire, In this evaluation, patients are asked to evaluate the care and treatment in the health facility using a 4-point Likert scale, ranging from strongly disagree to strongly agree.
On the other hand, the preparation for discharge from hospital and the subsequent period are also surveyed.
The latter is conducted only in patients transferred from a participating center or in those going home after admission to rehabilitation.
The higher the outcome score the higher the stroke patients' and informal caregivers' satisfaction is with hospital stroke care.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of patient/ informal caregivers: Patient Participation
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Patient Participation: Via the Patient Participation in Rehabilitation Questionnaire, patients' experiences of participation in their rehabilitation will be assessed.
This evaluation will be evaluated as an optional scale.
Only for participants who are able to fulfill this questionnaire based on cognition or on level of load ability.
The Patient Participation in Rehabilitation Questionnaire contains 20 items, scoring is based on a five point-likert scale varying from always agree to never agree.
The higher the score the higher according to the patient/informal caregiver wishes the involved in their care is.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of patient/ informal caregivers, Patient empowerment:
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Patient empowerment: Through the Health Care Empowerment Inventory, patients or informal caregivers are asked about their engagement with the patient about their healthcare.
Using eight statements, the patient or informal caregiver must indicate the extent to which they agree or disagree with each of the following statements.
The higher the score the higher the patient/informal caregiver wishes to be involved in their healthcare.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of patient/ informal caregivers, Level of depression:
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Level of depression: Via the Patient Health Questionnaire-9 (PHQ-9) the mental functioning is evaluated.
The PHQ-9 is the depression module, which scores each of the 9 Diagnostic Statistical Manual of Mental Disorders-IV criteria as "0" (not at all) to "3" (nearly every day).
The lower the score, the lower the change of a depression are.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of patient/ informal caregivers, general Self-Efficacy
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Level of helplessness/self-efficacy scale The first questionnaire evaluated the level of self-efficiency through the General Self-Efficacy Scale.
This questionnaire is a mandatory questionnaire.
The General Self-Efficacy Scale concerns a unidimensional questionnaire that measures how a person generally copes with stressors/difficult situations in life.
It involves ten statements (optimistic 'self-beliefs') that ask about how one thinks and acts in general.
The scale consists of 10 statements.
For each statement, responders must answer on a 4-point likert scale, ranging from completely incorrect to completely correct.
The higher the score, the more confident the patient/informal caregiver is that his or her actions are responsible for successful outcomes.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of patient/ informal caregivers, stroke self-efficacy:
Time Frame: Baseline and immediately after the intervention/admission to the healthcare institution
|
• Level of helplessness/self-efficacy scale The second questionnaire evaluated the level of self-efficiency through the Stroke self-efficacy questionnaire.
This questionnaire is an optional questionnaire.
The Stroke self-efficacy questionnaire is a 13-item self-report scale measuring self-efficacy judgements in specific domains of functioning post stroke.
Individuals rate their belief in their ability to achieve each of the 13 items on a 10-point scale, where 0 = not at all confident to 10 = very confident.
The higher the score the higher the patient/informal caregiver's self-confidence in functional performance.
|
Baseline and immediately after the intervention/admission to the healthcare institution
|
Evaluation of professional healthcare providers: Satisfaction of employees in healthcare
Time Frame: Baseline and immediately after the intervention
|
• Satisfaction of employees in healthcare survey Through the Satisfaction of employees in healthcare survey, 20 statements are shown to healthcare professionals.
For each statement, healthcare professionals have to score the statement using a 4 point likert scale, ranging from strongly disagree to strongly agree.
A higher score indicated on the statement corresponds to a higher level of satisfaction with their work setting.
|
Baseline and immediately after the intervention
|
Evaluation of professional healthcare providers; Self- efficacy
Time Frame: Baseline and immediately after the intervention
|
• Self- efficacy in patient centeredness questionnaire A 27-statement questionnaire asks healthcare professionals about how doctors and caregivers interact and communicate with patients.
Participants can answer using a 5-point likert scale ranging from the answer option very little to very much.
This questionnaire contains 3 main topics; 1) exploring the patient perspective, 2) sharing information and power and 3) Dealing with communicative challenges.
A higher score corresponds to more confidence in dealing with patients.
|
Baseline and immediately after the intervention
|
Evaluation of professional healthcare providers; Acceptability of Intervention Measure, Intervention Appropriateness Measure, & Feasibility of Intervention Measure questionnaire
Time Frame: 1-2 months after study start, at 4 months after study start and immediately after the intervention
|
Through a questionnaire (Acceptability of Intervention Measure, Intervention Appropriateness Measure, & Feasibility of Intervention Measure questionnaire) professional healthcare professionals are asked if they can assess whether the programme is appropriate and feasible and whether they accept the programme.
A total of 12 statements are presented to participants where for each statement the participant has to indicate via a 5-point likert scale (ranging from Completely disagree to Completely agree) to what extent they agree or disagree with the statement.
|
1-2 months after study start, at 4 months after study start and immediately after the intervention
|
Feedback on the goal setting programme and implementation strategies.
Time Frame: 2-3, 5 and 8 months after study start.
|
Through a semi-structured interview or focus group, both professional caregivers and patients/ informal caregivers are asked for their feedback on the programme and the implementation strategies used.
|
2-3, 5 and 8 months after study start.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Annemie Spooren, prof dr, UHasselt
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Goal setting in Stroke
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Stroke
-
University Hospital, GhentRecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Stroke HemorrhagicBelgium
-
Moleac Pte Ltd.RecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, CryptogenicSingapore, Philippines
-
Moleac Pte Ltd.Not yet recruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, Cryptogenic
-
IRCCS San Camillo, Venezia, ItalyRecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke HemorrhagicItaly
-
Vanderbilt University Medical CenterPatient-Centered Outcomes Research Institute; University of Alabama at BirminghamEnrolling by invitationStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Engagement, Patient | Stroke HemorrhagicUnited States
-
University of MinnesotaAmerican Occupational Therapy FoundationRecruitingStroke | Stroke Sequelae | Stroke Hemorrhagic | Stroke IschemicUnited States
-
University of British ColumbiaCanadian Institutes of Health Research (CIHR); Michael Smith Foundation for...RecruitingStroke | Stroke, Ischemic | Stroke Hemorrhagic | Chronic StrokeCanada
-
University of CincinnatiMedical University of South Carolina; University of California, Los Angeles; University...RecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke HemorrhagicUnited States
-
Turkish Stroke Research and Clinical Trials NetworkElectroCore INC; Turkish Neurological SocietyCompletedStroke | Stroke, Ischemic | Stroke, Acute | Stroke, HemorrhagicTurkey
-
University of LiegeCompletedStroke, Acute | Stroke Hemorrhagic | Stroke, ComplicationBelgium
Clinical Trials on Goal setting improvement program
-
Baylor College of MedicineEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompletedObesity | CancerUnited States
-
Hadassah Medical OrganizationRecruiting
-
Tzu-Ting HuangCompletedRisk Reduction Behavior | Reduce Risk of DementiaTaiwan
-
Universiteit LeidenRecruitingFuture Orientation | Self-defeating Behavior | Future Self-identificationNetherlands
-
Milton S. Hershey Medical CenterNational Institutes of Health (NIH); National Institute on Aging (NIA)Enrolling by invitationOverweight and Obesity | Walking | Physical Inactivity | Self-regulation | Cognitive HealthUnited States
-
Klinik ValensCompletedShared Decision MakingSwitzerland
-
Marquette UniversityFroedtert HospitalRecruiting
-
Dartmouth-Hitchcock Medical CenterTerminatedMetastatic Breast CancerUnited States
-
Milton S. Hershey Medical CenterChildren's Miracle NetworkCompleted
-
Sunnybrook Health Sciences CentreUniversity of OttawaCompleted