Stroke patient and carer experiences of Functional Electrical Stimulation (FES) as provided through a Lothian drop foot clinic - a qualitative exploration.
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Shiels, J., Salisbury, L., Bulley, C., McGuire, C. & Wilkie, K. () Stroke patient and carer experiences of Functional Electrical Stimulation (FES) as provided through a Lothian drop foot clinic - a qualitative exploration., , , , ,
Functional electrical stimulation (FES) is the use of electrical stimulation to cause functional movement in muscles paralysed due to CNS lesions e.g. lifting the affected foot during walking. A pilot clinic providing FES to stroke patients has been running at the Astley Ainslie Hospital, Edinburgh since 2003. Following service audit and review, a proposal has been submitted to Lothian Health for the provision of a permanently funded clinic. In order to further support and enhance this application a qualitative project was undertaken to explore patients' and carers' experiences of FES and the pilot clinic. Methods: Semi-structured interviews were undertaken by an independent interviewer, on 10 carers and 13 patients using a focused topic guide. Interpretative Phenomenological Analysis was used as a framework for thematic analysis of the transcripts. Rigour was ensured by using participant verification and checking of themes. Results: The general consensus from patients was that they found FES of value with improvements in functional ability, participation and quality of life. These effects also impacted positively on the lives of carers. While they felt that positives outweighed the negatives, some limitations were identified as areas for development. Further themes were identified in relation to the dedicated clinic, including value placed on expert consultation and peer support, as well as barriers to initial referral. Conclusions: This qualitative research has supported the evidence gained from the previous quantitative evaluation of the clinic. The positive impacts articulated by both patients and carers have provided in-depth insights into the benefits demonstrated by the application of FES beyond the physical improvements of gait parameters routinely recorded e.g. less dependence on carers and increased participation in social, domestic and occupational activities. Issues raised by both patients and carers support current service provision and highlighted areas for further enhancing service delivery.