Table 3 Stroke nurses’ perceptions pre-intervention

“What hinders us is the lack of resources and services that are in Highland, and how remote our caseload is …erm… you’ve got some people that live in Inverness that have got access to services everywhere, which is fantastic, and then you’ve got patients fifty miles away that can’t access anything …and that is a severe barrier to being able to … get these people to self-manage, it’s just because they are on their own, you know, [and] unless they have got familyit’s very difficult.” (SN1, Highland)

“There’s new websites, the new workbook, the lifestyle [course] you’ve [speaking to another nurse] been doing it a few years but it’s still a new concept and so it’s, what do you offer people? You know, somebody said “there is people that you don’t offer anything to if it’s appropriate” [sic] they are not at that stage or are never going to want that type of thing or there are people that are maybe at different stages and not maybe a group person and nobody wants to work through a manual and not everybody can go online. my view about some of the interventions as well, none of them are golden goose eggs in the sense that they help people in their recovery well some help some people …erm… but there is nothing that’s like some sort of magic wand.” (SN4, Lanarkshire)

“I think that’s the challenges … we are always trying to find better ways to do things and [the question is] how that’s all joined up because, you know … there is always [sic] people coming up with different ways and ideas to look at things, and how does that become… joined up …?” (SN4, Fife)

Intervention

“Depending on what else you are doing that visit … you know, if you were going into this individuals’ to do that then it probably is okay … but if you had anything else to go over on that visit then no, it probably is a bit long … and to try and keep a stroke patients concentration for that long is very difficult, because I find myself, after about thirty minutes, you have lost them … (SN1, Highland)