Access G-AP: development of an accessible goal setting and action planning resource for stroke survivors with aphasia

Abstract

Purpose

Goal setting is key to stroke rehabilitation, but access for people with aphasia is challenging. Based on the Goal setting and Action Planning (G-AP) framework, we developed an accessible goal setting resource (Access G-AP).

Methods

Access G-AP was designed using a three-phase, user-centred design process. Phase 1: Access G-AP Draft A was designed using evidence-based recommendations. Phase 2: Draft A was reviewed by stroke survivors with aphasia (focus groups 1&2) and rehabilitation staff (questionnaire). Phase 3: Suggested recommendations informed Access G-AP Draft B, which was further reviewed by stroke survivors with aphasia (focus group 3). The final version of Access G-AP was approved by stroke survivors with aphasia at a debrief meeting. Data were analysed using content analysis.

Results

Recommended design improvements included reducing text, adding bullet points, and diversifying images. Both participant groups highlighted that Access G-AP should be used collaboratively to support stroke survivor involvement. Staff recommended Access G-AP training and additional resources to support stroke survivors with severe aphasia.

Conclusions

Access G-AP was co-developed to support people with aphasia to access and engage in stroke rehabilitation goal setting. Further research is required to establish the feasibility of Access G-AP in clinical practice.

IMPLICATIONS FOR REHABILITATION

• Evidence-based accessible formatting strategies and an iterative design process can inform the design of accessible goal setting resources.

• Accessible goal setting materials should be relevant to stroke survivors with aphasia and responsive to their needs.

• Rehabilitation staff require training and support to use accessible goal setting resources (like Access G-AP) with stroke survivors with aphasia, especially those with severe aphasia.

• Evaluation of the feasibility of Access G-AP in clinical practice is now required.

Keywords:

• Aphasia
• stroke
• rehabilitation
• goal setting
• accessibility

Acknowledgements

We would like to thank the stroke survivors with aphasia and rehabilitation staff who generously gave their time to participate in the study and share their perspectives.

Disclosure statement

EB was supported by a Glasgow Caledonian University PhD studentship and Foundation for Women Graduates Foundation grants. LS is supported by a Stroke Association Clinical Lectureship award (TSA LECT 2016/02). The Nursing, Midwifery, and Allied Health Professions Research Unit and MCB are supported by the Chief Scientist Office, Scottish Government Health, and Social Care Directorate, UK. The views expressed here are those of the authors and not necessarily those of the funders.