Experiences of implementation and perceived impacts of dyad-focused strategy training: Perspectives from stroke survivors, caregivers, and therapists

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Abstract
Objective: To explore stroke survivors’, caregivers’, and therapists’ experiences of the implementation and perceived impacts of the Dyad-Focused Strategy Training program. Design: A qualitative descriptive study using semi-structured interviews and thematic analysis. Setting: Six academic medical centers in Taiwan. Participants: Forty-one stroke survivor-caregiver dyads and 10 occupational therapists who completed the Dyad-Focused Strategy Training intervention. Intervention: The Dyad-Focused Strategy Training program is a therapist-guided, dyadic intervention focused on shared goal setting, problem-solving, and strategy development to improve stroke rehabilitation outcomes. Main Outcome Measures: Thematic analysis identified key themes related to therapists’ roles, benefits for dyads, implementation challenges, and therapists’ professional reflections. Results: Two overarching themes emerged: (1) Experiences with Dyad-Focused Strategy Training Implementation—participants emphasized the essential role of therapists, the emotional benefits of personalized strategies, and the complexity of balancing differing goals, fluctuating motivation, and emotional challenges within dyads; (2) Perceived Impact of Dyad-Focused Strategy Training on Individual, Dyadic, and Professional Outcomes—survivors reported improved independence and participation, caregivers noted reduced stress and clearer caregiving strategies, dyads described strengthened emotional bonds and communication, and therapists experienced professional growth and deeper insight into dyadic dynamics. Conclusions: Dyad-Focused Strategy Training fostered meaningful improvements in participation of stroke survivors and caregivers, survivor independence, and caregiver well-being, while contributing to therapist development. Addressing emotional and motivational challenges and providing structural support to therapists are key for successful and sustainable implementation in clinical practice.
Funding Information
  • Taipei Medical University - Wan Fang Hospital (114TMU-WFH-01)
  • National Science and Technology Council (NSTC 113-2326-B-038-002-MY3)
  • National Health Research Institutes of Taiwan (NHRI-EX114-11408PI)
  • Ministry of Science and Technology, Taiwan (MOST 111-2628-B-038-015-MY3)

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