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dc.contributor.authorParker, J.*
dc.contributor.authorMawson, S.*
dc.contributor.authorMountain, Gail*
dc.contributor.authorNasr, N.*
dc.contributor.authorZheng, H.*
dc.date.accessioned2016-12-16T15:45:22Z
dc.date.available2016-12-16T15:45:22Z
dc.date.issued2014-06
dc.identifier.citationParker J, Mawson S, Mountain G et al (2014) Stroke patients’ utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluation. BMC Medical Informatics and Decision Making. 14(1): 46.en_US
dc.identifier.urihttp://hdl.handle.net/10454/10993
dc.descriptionYesen_US
dc.description.abstractBackground: Evidence indicates that post − stroke rehabilitation improves function, independence and quality of life. A key aspect of rehabilitation is the provision of appropriate information and feedback to the learner. Advances in information and communications technology (ICT) have allowed for the development of various systems to complement stroke rehabilitation that could be used in the home setting. These systems may increase the provision of rehabilitation a stroke survivor receives and carries out, as well as providing a learning platform that facilitates long-term self-managed rehabilitation and behaviour change. This paper describes the application of an innovative evaluative methodology to explore the utilisation of feedback for post-stroke upper-limb rehabilitation in the home. Methods: Using the principles of realistic evaluation, this study aimed to test and refine intervention theories by exploring the complex interactions of contexts, mechanisms and outcomes that arise from technology deployment in the home. Methods included focus groups followed by multi-method case studies (n = 5) before, during and after the use of computer-based equipment. Data were analysed in relation to the context-mechanism-outcome hypotheses case by case. This was followed by a synthesis of the findings to answer the question, ‘what works for whom and in what circumstances and respects?’ Results: Data analysis reveals that to achieve desired outcomes through the use of ICT, key elements of computer feedback, such as accuracy, measurability, rewarding feedback, adaptability, and knowledge of results feedback, are required to trigger the theory-driven mechanisms underpinning the intervention. In addition, the pre-existing context and the personal and environmental contexts, such as previous experience of service delivery, personal goals, trust in the technology, and social circumstances may also enable or constrain the underpinning theory-driven mechanisms. Conclusions: Findings suggest that the theory-driven mechanisms underpinning the utilisation of feedback from computer-based technology for home-based upper-limb post-stroke rehabilitation are dependent on key elements of computer feedback and the personal and environmental context. The identification of these elements may therefore inform the development of technology; therapy education and the subsequent adoption of technology and a self-management paradigm; long-term self-managed rehabilitation; and importantly, improvements in the physical and psychosocial aspects of recovery.en_US
dc.description.sponsorshipThis paper is part of the SMART programme of research funded by Engineering and Physical Sciences Research Council (EPSRC).en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttp://dx.doi.org/10.1186/1472-6947-14-46en_US
dc.rights© 2014 Parker et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.en_US
dc.subjectStrokes; Rehabilitation; ICT; Feedbacken_US
dc.titleStroke patients’ utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluationen_US
dc.status.refereedYesen_US
dc.date.Accepted2014-04-22
dc.typeArticleen_US
dc.type.versionPublished versionen_US
refterms.dateFOA2018-07-25T15:48:43Z


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