Development of the "Kalmer" relaxation intervention: co-design with stroke survivors with aphasia

Disabil Rehabil. 2023 May;45(9):1517-1529. doi: 10.1080/09638288.2022.2069294. Epub 2022 May 13.

Abstract

Purpose: Anxiety is common after stroke and more prevalent in survivors with aphasia. Relaxation is an effective first-line therapy. The current study aimed to obtain the perspectives of stroke survivors with aphasia to inform the development of an accessible, technology-based, relaxation intervention.

Materials and methods: Qualitative co-design methods were used with twelve people with aphasia after stroke. The "Kalmer" Relaxation treatment package materials were iteratively based on participants' experiences and preferences; barriers and facilitators to treatment compliance were explored. Participants were also asked to consider how the intervention might be evaluated in a research trial.

Results: A thematic analysis highlighted the importance and need for the development of an appropriate and inclusive relaxation product, to be implemented by health professionals early post-stroke. Several behavioural strategies to improve treatment adherence were recommended. Participants had varying perspectives on clinically meaningful treatment outcomes.

Conclusions: Overall, a co-designed accessible relaxation product was viewed as a necessary component of usual stroke care. Acceptability and feasibility and preliminary efficacy of the "Kalmer" intervention should be trialled in future studies. IMPLICATIONS FOR REHABILITATIONCo-designing psychological interventions for people with aphasia after stroke is needed to meet the needs of this at-risk population.Technology-based relaxation interventions to manage anxiety after stroke are viewed positively by people with aphasia and deemed acceptable and feasible.Clinical trials of these co-designed relaxation interventions are required before recommending integration into routine practice.

Keywords: Relaxation; aphasia; co-design; qualitative; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aphasia* / etiology
  • Aphasia* / psychology
  • Aphasia* / therapy
  • Humans
  • Speech Therapy
  • Stroke* / complications
  • Stroke* / psychology
  • Survivors
  • Treatment Outcome