Experiences of implementation and perceived impacts of dyad-focused strategy training: Perspectives from stroke survivors, caregivers, and therapists

Abstract

ObjectiveTo explore stroke survivors', caregivers', and therapists' experiences of the implementation and perceived impacts of the Dyad-Focused Strategy Training program.DesignA qualitative descriptive study using semi-structured interviews and thematic analysis.SettingSix academic medical centers in Taiwan.ParticipantsForty-one stroke survivor-caregiver dyads and 10 occupational therapists who completed the Dyad-Focused Strategy Training intervention.InterventionThe Dyad-Focused Strategy Training program is a therapist-guided, dyadic intervention focused on shared goal setting, problem-solving, and strategy development to improve stroke rehabilitation outcomes.Main Outcome MeasuresThematic analysis identified key themes related to therapists' roles, benefits for dyads, implementation challenges, and therapists' professional reflections.ResultsTwo overarching themes emerged: (1) Experiences with Dyad-Focused Strategy Training Implementation-participants emphasized the essential role of therapists, the emotional benefits of personalized strategies, and the complexity of balancing differing goals, fluctuating motivation, and emotional challenges within dyads; (2) Perceived Impact of Dyad-Focused Strategy Training on Individual, Dyadic, and Professional Outcomes-survivors reported improved independence and participation, caregivers noted reduced stress and clearer caregiving strategies, dyads described strengthened emotional bonds and communication, and therapists experienced professional growth and deeper insight into dyadic dynamics.ConclusionsDyad-Focused Strategy Training fostered meaningful improvements in participation of stroke survivors and caregivers, survivor independence, and caregiver well-being, while contributing to therapist development. Addressing emotional and motivational challenges and providing structural support to therapists are key for successful and sustainable implementation in clinical practice.

Keywords: Rehabilitation interventions; occupational therapy; qualitative study; stroke.