Exploring the experience of facilitating self-management with minority ethnic stroke survivors: a qualitative study of therapists’ perceptions

Abstract

Purpose: The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. Methods: 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results: Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. Conclusions: This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences.

Implications for Rehabilitation

• Stroke therapists suggest that ethnicity should not be considered a barrier to successful engagement with a stroke specific self-management programme.

• Health, illness and recovery beliefs along with religion and the specific role of the family do however need to be considered to maximize the effectiveness of the programme.

• A number of the facilitators and barriers identified are not unique to stroke survivors from ethnic minority communities, nor shared by all.

• The therapists skills at negotiating identified barriers to self-management are highlighted as an area for further development.

• Ethnicity
• self-management
• stroke
• therapists

Acknowledgements

We would like to thank all the participants for their time and expertise. Additional thanks are due to Arnold Lloyd and Tess Baird for their support and the reviewers for the very helpful comments.