Table 3.
Enablers to delivering the outdoorjourney intervention with examples ^
| Social influences: Helpful or positive influences from people with stroke, family members, health professionals and community service providers that encouraged delivery of the outdoor journey intervention. Influences included people expecting the intervention to be offered or provided, tolerance for risk and enabling organisational policies. |
| From people with stroke: She's ...very motivated... keen to get back to catching the bus to the shops. She'll be good to work with. [On] my first visit last week, we walked up to the bus stop. She was lacking confidence... 'Are you sure it's not too early?'. I said 'No. It's not too early'. (PT3) |
| From policy: Our [community service] workers will take the person out if we specify 'The person can't go [shopping] on their own, so go with them. We want to encourage them [the person with stroke] to go. Take the patient with you'. (OT3) |
| Belief about capabilities: Positive beliefs about individual abilities, and the ability of the team, to provide the intervention. Therapists' beliefs could change over time. |
| Road crossing.....(long pause) I haven't really taken people across roads much at all. But we could do it...we could do it. We'd have to choose the roads...it's pretty scary out there [at the hospital entrance]...I take my life in my hands when I cross out there (laughs). (PT1) |
| [I was] thinking 'If someone has a heart condition, what would you do if they did collapse and you're on your own?'. They're the kind of things that go through your mind when you haven't done it. ... [so] it's helpful to have suggestions so that you're really prepared. So yeah, I've definitely started pre-thinking and trying to be as prepared as possible before going out (OT1) |
| Professional role identity: Therapists who believed the intervention was compatible with, or could become part of, their professional role or the role of another team member. Having a positive attitude to role sharing and role expansion. |
| In the initial interview we ask questions about ... shopping and banking and finances... how do they get there? Do they get public transport or drive? But beyond that, actually implementing anything is limited... [it is] something we should focus on (OT2) |
| Memory and attention: Triggers and prompts that would help to remind therapists to think about, discuss and document outdoor mobility and travel. |
| I think it should be in a questionnaire...that the OT and physio ask the client on [their] first meeting... More defined questions [like] " Do you want to go back to driving?" (OT2) |
| The [initial assessment] proforma that I'm using now goes into greater detail [about community access and transport] (OT5). |
| Emotions: Therapists who felt positive emotions, including joy and satisfaction, from delivering the intervention. |
| They [the therapists] enjoy it. [They say] 'I took them on the bus today and went to the shops'. (OT3) |
| They might be reluctant at first...but...you talk to them at the end and they [say] 'I know why I was pushed to do that' or 'If you weren't seeing me, I probably wouldn't have gotten to the stage that I am, trying to do this on my own'. Patients saying 'My confidence is so much better now, I don't think I would have got back to the bus if you didn't take me'. That's really ... rewarding. (PT3) |
Notes. ^ The following abbreviations are used after quotations, to represent each profession: occupational therapy (OT); physiotherapy (PT); speech pathology (SP); and social work (SW). Numbers (eg OT1, PT2) correspond to de-identified individual professionals as shown in Table 1.