Background/Aims: Take Charge After Stroke (TACAS) is an evidence-based intervention that supports people to ‘take charge’ of their recovery. While effective in improving independence, it is not embedded in usual care in stroke services in New Zealand. This study sought to understand the experiences implementing TACAS in a community stroke organisation to provide insights for future service provision.
Methods: A Qualitative Description study. Data included surveys with people with stroke (clients) and community stroke advisors (providers); fidelity data; and interviews and focus groups with clients, providers, and managers. Data were analysed using conventional content analysis and normalisation process theory (NPT).
Results: TACAS was perceived to help some clients and families look differently at their stroke and their future and identify what was meaningful. However, it was not universally needed, appropriate or accessible. At face value, TACAS appeared simple to provide, but was a sophisticated practice that differed from usual practice, reliant on therapeutic relationships and skilful communication. Different elements of TACAS appeared to support different outcomes. Providers needed support to integrate into usual practice in ways that maintained the core theoretical and empirical underpinnings of TACAS.
Conclusion: TACAS may be one of a suite of tools that can enable supported self-management, embedded in therapeutic relationships which support people to move toward a place of being able to take charge of life after stroke. While TACAS has significant value, we identify a number of areas that need to be addressed so that providers can ‘normalise’ TACAS within everyday practices.