About steppingout
Stepping Out is a self-management training programme designed specifically for individuals after stroke to support the development of self-management skills. Stepping Out has been developed following consultation with stroke survivors, carers and stroke professionals, and has been piloted in three parts of the UK.
The programme includes a training workshop for healthcare professionals and one-to-one training sessions for stroke survivors with a trained therapist or nurse. All sessions are supported by an interactive stroke workbook. The stroke workbook has been designed to provide an opportunity for stroke survivors to set targets and record success, and also read about other stroke survivors and the strategies they have used. The stroke workbook was finalised following a consultation day with Connect (the national UK charity for people with communication disabilities – see link below), making the workbook more accessible for people with aphasia.
For more information on aphasia visit Connect at: http://www.ukconnect.org/
Stroke is still the most complex and prevalent disability in the UK, affecting over 130,000 people in England and Wales each year and costing £4.2 billion in terms of lost productivity, disability and informal care costs annually.
Most individuals receive a limited period of stroke rehabilitation after which few have access to therapy in the longer term. Research has shown that some individuals can have a reduced quality of life after stroke, and reports of depression are high in some populations.
Although some individuals will develop effective self-management strategies without specific training and express a desire to take control of their lives, many individuals do not feel adequately prepared to cope after discharge from therapy.
The theoretical basis for Stepping Out is the psychological construct of self-efficacy (Bandura, 1997). The training programme and workbook are based on this theory and have been developed following consultation with stroke survivors, carers and stroke professionals. The research formed the main part of Fiona Jones’ PhD.
Self-management programmes based on self-efficacy theory have been shown to be more effective than educational approaches alone. Benefits include evidence of increased self-exercising, reduction in mood disorders, decrease in pain and improved quality of life in individuals who have received the programmes.
Stepping Out aims to enable stroke survivors to develop effective self-management skills which they can use in the long term. This has the potential to reduce the level of disability and care support required. Enhancing the self-management skills of individuals after stroke offers the potential to improve the quality of life and coping skills for individuals, their carers and families.
This programme will also enable PCTs to meet the requirements set out in the Government’s White Paper Supporting people with long term conditions to self-care as well as Quality Markers 10 (access to specialist rehabilitation), 12 (transfer of care) and 13 (long term care and support) of the UK Stroke Strategy (2007). This will increase the skills of rehabilitation teams to deliver effective self-management training programmes for stroke survivors.
For more information on these policies, visit the links below:
Supporting People with Long Term Conditions to Self-care:
This is a completely new approach to stroke rehabilitation. Whilst there are stories of how individuals have overcome initial disabilities from stroke through sheer determination, the process of how to increase therapists’ and other health professionals’ skills in this approach has not been developed before. Currently there are no interactive tools or programmes to support the development of self-management strategies in stroke survivors based on empirical research.
The main advantage of this approach is that therapists facilitate the empowering of stroke survivors and carers to set, record and evaluate their own goals. This can assist in enabling stroke survivors to take control of their rehabilitation.