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(MRC DTP) Development and feasibility trial of a psychological support intervention to improve well-being and adjustment in life after stroke

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  • Full or part time
    Dr Emma Patchwood
    Prof A Bowen
    Dr S Knowles
  • Application Deadline
    No more applications being accepted
  • Competition Funded PhD Project (European/UK Students Only)
    Competition Funded PhD Project (European/UK Students Only)

Project Description

Stroke can leave many survivors experiencing long-term psychological distress, including issues with emotions and anxiety. National stroke service audits and stroke survivor self-report consistently report inadequate psychological support after stroke – particularly in the long-tem. There is an urgent need for evidence-based, clinically and financially effective psychological interventions that can be feasibly delivered for community-based stroke survivors.

Acceptance and Commitment Therapy (ACT) is a promising psychological intervention for stroke. It is a third wave cognitive-behavioural therapy that encourages clients to adjust to – and accept – current experiences and ‘commit’ to behaviours that are congruent with their personal values, in order to promote psychological well-being. Living Well with Neurological Conditions (LWNC) is an ACT-based psychological support intervention for groups, completed over eight weekly sessions. It includes mindfulness practice and experiential exercises to help clients identify their personal goals and values. LWNC was developed by expert Clinical Neuropsychologists and has been used in NHS settings. It has good proof-of-principle for improving well-being in clinical populations experiencing psychological distress, but needs some development and testing to explore its value in stroke populations.

This project will systematically examine the strength of the current evidence for ACT-based interventions in treating post-stroke psychological distress, followed by two core stages to develop and test the proposed LWNC intervention:
• DEVELOPMENT STAGE: Adaptation of the existing LWNC course for stroke survivors, to ensure suitability for individuals experiencing common post-stroke difficulties with cognition and communication. A workforce is needed to deliver the course, so in this phase we also develop a workforce training programme, suitable for professionals without formal clinical training.
• TESTING STAGE: Conducting a feasibility randomised controlled trial (RCT) of the adapted LWNC to explore acceptability to stroke survivors and course facilitators. This will also include a qualitative examination of treatment fidelity, as well as defining the design specifications for a phase 3 RCT that will robustly test LWNC effectiveness for treating psychological distress in stroke survivors.

All aspects of the project will involve collaboration with stroke survivors and carers, the Stroke Association, Clinical Neuropsychologists and expert researchers. Project outcomes will include the production a co-developed group psychological intervention and workforce training programme that has potential to enhance stroke survivors’ well-being and quality of life.
The component studies of the PhD will have a particular emphasis on: reviewing the evidence base; developing methods to understand intervention fidelity and acceptability through process evaluation and qualitative methodologies, respectively.

https://www.research.manchester.ac.uk/portal/en/researchers/emma-patchwood(7ef3b4bb-aaae-40cb-a6e4-112efe225d5e).html
https://www.research.manchester.ac.uk/portal/en/researchers/audrey-bowen(def6df3d-2d0b-4701-a800-68ef1772da4d).html
https://www.research.manchester.ac.uk/portal/en/researchers/sarah-knowles(00d8811b-1372-41d9-90ab-f7d5b93eb2fb).html
https://www.bmh.manchester.ac.uk/research/domains/neuroscience-mental-health/stroke/


Entry Requirements
Applications are invited from UK/EU nationals only. Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.

Funding Notes

This project is to be funded under the MRC Doctoral Training Partnership. If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form - full details on how to apply can be found on the MRC DTP website www.manchester.ac.uk/mrcdtpstudentships

As an equal opportunities institution we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.

References

1. Intercollegiate Stroke Working Party. National Clinical Guideline for Stroke, 5th edition (eds Bowen A, James M, Young G). London: Royal College of Physicians, 2016. https://www.strokeaudit.org/Guideline/Guideline-Home.aspx

2. Hill, G., et al. (2017). Living well with neurological conditions: Evaluation of an ACT-informed group intervention for psychological adjustment in outpatients with neurological problems. The Neuropsychologist, 3, 58 – 63.

3. Craig P., et al (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance BMJ; 337 :a1655

4. Moore G.F., et al (2015). Process evaluation of complex interventions: Medical Research Council guidance BMJ; 350 :h1258

5. Hoffmann, T.C., et al., [Better Reporting of Interventions: Template for Intervention Description and Replication (TIDieR) Checklist and Guide]. Gesundheitswesen, 2016. 78(3): p. 175-88.



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