Unpacking the black box of nursing and therapy practice for post-stroke shoulder pain: a precursor to evaluation

Objectives: To describe current nursing and therapy interventions for the p revention and treatment of post-stroke shoulder pain and to explore the ext ent of their reported use in England. Design: Semi-structured, themed interviews followed by a postal questionnai re. Participants: Six nurses, five occupational therapists (OTs) and six physio therapists (PTs) were interviewed. Twelve nurses, 12 OTs and 12 PTs were se nt the pilot questionnaire and the main questionnaire was posted to 332 nur ses, 332 OTs and 332 PTs. Setting: NHS Trusts in England which provide acute stroke care/rehabilitati on. Procedure: Two researchers independently condensed the transcripts of the i nterviews into a list of interventions which were then transformed into a p ilot postal questionnaire. Following the pilot small changes were made. Par ticipants sent the main questionnaire were given three weeks to return it b efore being posted a reminder. After a further two weeks a researcher gave a telephone reminder. Results: One hundred and seventy-five different types of interventions were identified. The main questionnaire (57.8% response rate) found that all of the interventions were used by at least one respondent and that only 22.9% of the interventions were used to the same extent by nurses, OTs and PTs. The data also suggest variation in reported use within professions. Conclusions: This study has found a large number of interventions for post- stroke shoulder pain which are reported to be used. This might reflect diff erent causes of shoulder pain or variation between clinicians. Answers to t hese questions are expected to guide future evaluative research.