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Background:Equal, collaborative and therapeutic relationships centred on the person affected by stroke are important for supporting recovery and adjustment. However, realising these relationships in hospital practice is challenging when there is increasing focus on biomedical needs and organisational pressures. Despite a body of evidence advocating for quality relationships, there remains limited research describing how to achieve this in clinical practice. This appreciative action research (AAR) study aimed to describe the processes involved in co-creating meaningful relationships on stroke units.Design and methods:An AAR approach was used to develop humanising relationship-centred care (RCC) within two hospital stroke units. Participants were staff (n = 65), patients (n = 17) and relatives (n = 7). Data generation comprised of interviews, observations and discussion groups. Data were analysed collaboratively with participants using sense-making as part of the AAR cyclical process. Further in-depth analysis using immersion crystallisation confirmed and broadened the original themes.Findings:All participants valued similar relational experiences around human connections to support existential well-being. The AAR process supported changes in self, and the culture on the stroke units, towards increased value being placed on human relationships. The processes supporting human connections in practice were: (i) sensitising to humanising relational knowing; (ii) valuing, reflecting and sharing relational experiences with others that co-created a relational discourse; and (iii) having the freedom to act, enabling human connections. The outcomes from this study build on existing lifeworld-led care theories through developing orientations for practice that support relational knowing and propose the development of RCC to include humanising values.

Oral abstracts- UKI-CC-B1.1 P97.

Evaluation of three arts activities (dance for people experiencing Parkinson’s, art for people with mild to moderate memory loss and art for parents experiencing different challenges) was undertaken. The overall task was to provide insights into whether the intended outcomes of the arts activities were achieved. A participatory approach to the evaluation was adopted and the evaluation took place over four years. This report provides detail of each of the activities, what was evaluated, how relevant information was gained from participants and the findings. The findings not only indicated that the activities were successful, they also provided insights into the secrets of success for others who may wish to establish similar projects in the future.

Introduction Research into the lived experience of CI describes discomfort, feeling isolated and ignored when interacting with SUP. Negative feelings are also described by SUP and relatives when attempting to communicate with patients with CI. Study Aim: To explore a humanising relationship-centred approach to support the development of positive relationships between patients, relatives and SUP. This abstract will present data specific to patients with CI. Methods A two-phase action research study with two stroke units over 20 months. Phase 1 explored the experiences of positive relationships with SUP, patients and relatives, and collaborated with SUP to develop and evaluate practices that supported relationships. Phase 2 used the practices developed in Phase 1 to explore translation to a second setting. Methods were participant observation, interviews, story-telling and group discussions. Processes of sense-making and immersion crystallisation were used to analyse data with staff as co-analysts. Results Three themes described the processes in clinical practice to support positive relationships: 1. Intentions by SUP or relatives to reach out towards, to try and connect with those with CI, was most meaningful for patients with CI. Successful transaction of information was less important. 2. Relatives and SUP used vicarious storytelling to share and maintain the uniqueness of the patient with CI. 3. Increasing SUP sensitivity to communicating beyond words – drawing on their emotional or tacit response during encounters. Conclusion This study has shown SUP using a humanising relationship-centred focus and wordless narratives support positive, therapeutic relationships. It offers new insights into practice developments beyond conventional supportive communication strategies.

Introduction: People often experience distress following stroke due to fundamental challenges to their identity. Objectives: To evaluate (1) the acceptability of ‘HeART of Stroke’ (HoS), a community-based arts and health group intervention, to increase psychological well-being; and (2) the feasibility of a definitive randomised controlled trial (RCT). Design: Two-centre, 24-month, parallel-arm RCT with qualitative and economic components. Randomisation was stratified by centre and stroke severity. Participant blinding was not possible. Outcome assessment blinding was attempted. Setting: Community. Participants: Community-dwelling adults ≤2 years poststroke recruited via hospital clinical teams/databases or community stroke/rehabilitation teams. Interventions: Artist-facilitated arts and health group intervention (HoS) (ten 2-hour sessions over 14 weeks) plus usual care (UC) versus UC. Outcomes: The outcomes were self-reported measures of well-being, mood, capability, health-related quality of life, self-esteem and self-concept (baseline and 5 months postrandomisation). Key feasibility parameters were gathered, data collection methods were piloted, and participant interviews (n=24) explored the acceptability of the intervention and study processes. Results: Despite a low recruitment rate (14%; 95% CI 11% to 18%), 88% of the recruitment target was met, with 29 participants randomised to HoS and 27 to UC (57% male; mean (SD) age=70 (12.1) years; time since stroke=9 (6.1) months). Follow-up data were available for 47 of 56 (84%; 95% CI 72% to 91%). Completion rates for a study-specific resource use questionnaire were 79% and 68% (National Health Service and societal perspectives). Five people declined HoS postrandomisation; of the remaining 24 who attended, 83% attended ≥6 sessions. Preliminary effect sizes for candidate primary outcomes were in the direction of benefit for the HoS arm. Participants found study processes acceptable. The intervention cost an estimated £456 per person and was well-received (no intervention-related serious adverse events were reported). Conclusions: Findings from this first community-based study of an arts and health intervention for people poststroke suggest a definitive RCT is feasible. Recruitment methods will be revised. Trial registration number: ISRCTN99728983.

This paper reports finding from a nested qualitative study designed to elicit the views and perceptions of those who participated in a randomised controlled feasibility trial testing a non‐pharmacological intervention, Respiratory Distress Symptom Intervention (RDSI), for the management of the breathlessness–cough–fatigue symptom cluster in lung cancer. Semi‐structured interviews were conducted with 11 lung cancer patients, three caregivers and seven researchers involved in recruitment, consent, RDSI training and delivery and participant follow‐up. Thematic analysis identified key considerations including: the importance of informed consent emphasising commitment to completion of paperwork and raising awareness of potential sensitivities relating to content of questionnaires; ensuring screening for the presence of symptoms reflects the language used by patients; appreciation of the commitment required from participants to learn intervention techniques and embed them as part of everyday life; conduct of interviews with patients who decline to participate; and conduct of serial interviews with those receiving RDSI to further inform its routine implementation into clinical practice. This study will inform the development of a fully powered follow‐on trial testing the hypothesis that RDSI plus usual care is superior to usual care alone in the effective management of this symptom cluster in lung cancer.

Poster presented at 12th International Society for Equitation Science Conference (ISES2016) to accompany: Steve North, Ann Hemingway, Andrew McLean, Harriet Laurie and Caroline Ellis-Hill. 2016. Evaluating a natural horsemanship program in relation to the ISES first principles of horse training. In proceedings of The 12th International Society for Equitation Science Conference (ISES2016). June 23-25. IFCE (Institut Français du Cheval et de L’équitation), Saumur, France.DOI: 10.5281/zenodo.54733. http://dx.doi.org/10.5281/zenodo.54733

This research reports a qualitative study to explore the behavioural responses to, and reported reflections from Young Offenders undertaking an Equine Facilitated Learning (EFL) Intervention in prison in the UK. Learning was facilitated by an instructor and the participants were taught introductory natural horsemanship skills. Establishments holding young adult prisoners are typically characterised by increased disruption to the regime, and with greater incidents of violence, bullying and conflict than in other types of prison. A resulting challenge for those working with young prisoners is the need to respond to increased levels of social isolation, and difficulties in managing impulsivity, problem solving, temper and conduct. It is hoped that this research will provide some initial evidence to contribute to ideas around the nature of learning practical positive skills and knowledge through inter species interactions.