Exploring allied health professionals’ perceptions and practice in Ireland regarding guideline recommendations for intensity of multidisciplinary therapy for stroke survivors: A qualitative study

Objective: To explore the attitudes and practice of allied health professionals working in stroke care in Ireland regarding recommended amounts of therapy set out in the National Clinical Guideline for Stroke (2023). Design: Qualitative descriptive study using one-to-one semi-structured interviews. Data were analysed using reflexive thematic analysis. Setting: Five large acute teaching hospitals in Dublin, Ireland. Participants: The 11 participants were allied health professionals working in acute and subacute stroke care in Dublin, and were recruited using a combination of purposive and snowball sampling. Results: Two main themes emerged: ‘Barriers and enablers to achieving guideline recommended therapy time’ and ‘Methods of increasing therapeutic time’. Patient factors and clinical resources impact on the provision of therapy post-stroke. Overall, participants felt positive about the recent guideline recommendation for increased therapeutic time. Various methods are employed to augment patient therapeutic time, including technology and semi-supervised practice. Participants perceived that Therapy Assistants play an important role in achieving greater amounts of therapy. Conclusions: Allied health professionals view the new Stroke Guidelines recommendation for increased therapy intensity as challenging but are generally positive in trying to achieve it, citing the benefits of increased therapy time for patient outcomes. They utilise a wide range of methods to optimise therapeutic time for stroke survivors. The role of the therapy assistant in supporting the delivery of larger amounts of therapy time warrants further evaluation.