The use of pluralistic evaluation to explore people's experiences of stroke services in the community

The aim of the present study was to explore the experience of stroke surviv ors and their informal carers of stroke services ia the community, as part of a pluralistic evaluation of a Pilot Community Stroke Service (PCSS) in N ottingham, England. The research design involved qualitative in-depth inter views with four main stakeholder groups in the evaluation, in combination w ith analyses of varied data sources, including participant observational an d documentary. In addition to interviews with 57 stroke survivors and their carers (as appropriate), interviews were conducted with the team of the PC SS, individually and as a group, and with a range of other workers. The plu ralistic approach of the evaluation revealed that tensions and social confl icts at the interface between services, and particularly between health and social care services, had a negative impact on the quality of life of clie nts and carers alike, which were experienced as 'setbacks' and which could be shown to be system induced Such System Induced Setbacks' also had negati ve consequences for the team of the PCSS, since rather than being: a 'top u p' service, in such cases it became a 'mop up' service, compensating for th e shortfall in service provision. Thus its aims and objectives could not: b e fully realized. It was concluded that pluralistic evaluation had a number ok: strengths including that, because of its attention to process and soci al context, if revealed the existence of System induced Setbacks and their negative and long-term impact on the daily lives of clients and carers, and on the team of the PCSS, in a way which would not have been possible had a quantitative approach been used.