Using Q Methodology to evaluate a day service for younger adult stroke survivors

Abstract: Q methodology was used in programme evaluation of the Cardiff Day Service, which was launched in July 1995 specifically for adult stroke survivors 18-55 years of age. The aim of the Service was to offer participants an opportunity to identify and pursue meaningful and realistic situations within the community that would enable them to meet their personal aspirations, and develop their full potential. The purpose of this study is its application as a tool for understanding, evaluating, and extending or redirecting this Day Service. A 41-item Q set pertaining to perceived benefits of the Cardiff Day Service was sorted by 18 Helpers, yielding five factors (psychological gains, social confidence, encourages communication, respite for carers, and sense of purpose). The Q set sorted by Users was reduced to 33 items, after pilot testing indicated that Users could not concentrate long enough to complete the longer sort. Seventeen User Q sorts resulted in six factors (new experiences, feeling valued, social recovery, security, prevents isolation, and general recovery). The evidence from this aspect of the programme evaluation suggests that the Service is a welcome initiative. Reconsideration of its structure led to a suggestion to establish two distinct branches, one to provide social support and another for rehabilitation support. Q methodology can continue to provide important input into the evolution of the Service by addressing questions about how best to meet the needs of pre-retirement individuals after stroke