Abstract
Background and aims
Stroke is a major cause of long-term disability, requiring strategies that promote autonomy and quality of life. Self-management plays a vital role in rehabilitation, empowering individuals to engage in recovery and maintain progress beyond clinical care. ComVida (Bridges-PT), a culturally adapted self-management program, was developed to support stroke survivors in Portugal. This study examines its feasibility and acceptability within post-stroke rehabilitation.
Methods
A mixed-methods study was conducted in two phases. Phase 1 used a single-arm pre-post design with stroke survivors (n=31) who attended personalized rehabilitation sessions integrating self-management principles. Outcomes included self-efficacy, physical function, emotional state, and health-related quality of life, assessed at baseline, 6 and 12 weeks. Phase 2 explored acceptability through three online focus groups (n=15), including stroke survivors, informal caregivers, and healthcare professionals, analyzed using reflexive thematic analysis.
Results
Phase 1 showed significant improvements over 12 weeks in self-efficacy (SSEQ: t=7.22, p<.001, mean difference=9.13, Cohen’s d=1.30); and physical function (SIS-16: t=8.68, p<.001, mean difference= 18.03, Cohen’s d=1.56), alongside a reduction in anxiety/depression (HADS: t=−4.47, p<.001, mean difference =−5.71, Cohen’s d=.80). Quality of life (SF-12v2) remained stable (PCS and MCS, p>.99). Phase 2 revealed high acceptability, with participants valuing peer narratives, goal-setting through small steps, and cultural relevance. Healthcare professionals reported positive changes in communication and empowerment strategies.
Conclusions
ComVida (Bridges-PT) is feasible and acceptable for stroke survivors in Portugal, showing promising short-term benefits in self-efficacy, functional independence, and emotional well-being. Findings support integrating culturally adapted self-management programs into post-stroke rehabilitation pathways.
Conflict of interest
CMP: nothing to disclose; DB: nothing to disclose; IB: nothing to disclose; TD: nothing to disclose; AMM: nothing to disclose.