Supporting Community Care and Support Workers (CCSWs) to use the Assessment of Quality of Life – Eight Dimensions (AQOL-8D) in a stroke rehabilitation team

Abstract

Executive summary This project was completed in partnership with a Community Stroke Service (CSS). The CSS is split into a North team and a South team that are made up of occupational therapists, community care and support workers (CCSWs) and physiotherapists. The service’s priority is to provide person-centred community-based stroke rehabilitation interventions. Information gathering is a crucial part of the occupational therapy process, as it supports the identification of a person’s occupational participation and performance needs (Royal College of Occupational Therapists [RCOT] 2017). Within the CSS, information gathering is completed by CCSWs. The occupational therapists communicated that reported findings about service users’ needs were not always detailed enough to begin intervention planning. The CSS decided they wanted to trial the use of the Assessment of Quality of Life – Eight Dimension (AQOL-8D) to support the information gathering process and use this tool as an outcome measure in the future. This service improvement project aimed to enhance CCSWs’ understanding of the AQOL 8D as an information gathering tool. An action research approach was taken, including the use of two methods. The first method was virtual education workshops about information gathering, outcome measures and the AQOL-8D that were delivered separately to the North and South teams. A total of 21 participants attended the education workshops. The second method was an online survey, which was used to collect data about the usefulness of the education workshops and the AQOL-8D in practice. A quantitative dominant mixed methods approach was selected for the online survey to allow exploration of the participants’ views from a quantitative and qualitative perspective. A total of 15 participants completed the survey. Results displayed that most participants ‘agree’ that their understanding of the education workshop topics was enhanced and that the AQOL-8D was easy to use in practice. Most respondents ‘neither agree nor disagree’ or ‘agree’ that the AQOL-8D enhanced communication between occupational therapists and CCSWs about service user 2

problems. Three themes were identified from the qualitative data, including ‘education workshops’, ‘administering the AQOL-8D’ and ‘lack of opportunity to use the AQOL-8D’. Key discussions included that data collection in stroke care can be challenging due to communication difficulties (Stroke Association 2021; Cameron 2000), ‘invasive’ questions and difficult conversations are necessary to engage in holistic practice (Priftanji et al. 2020), and the CSS may require more time to use the AQOL-8D in practice. Recommendations include considering a future project exploring the AQOL-8D as an outcome measure, or its usefulness for enhancing communication between occupational therapists and CCSWs; considering a future project exploring service user perspectives of the AQOL-8D; and that the participants may benefit from further skill development in having difficult conversations.