{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:56:35Z","timestamp":1787730995727,"version":"build-2784847793"},"reference-count":35,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000364","name":"Stroke Association","doi-asserted-by":"publisher","award":["SA PGF 21\\100008"],"award-info":[{"award-number":["SA PGF 21\\100008"]}],"id":[{"id":"10.13039\/501100000364","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand healthcare professionals\u2019 experiences of developing therapeutic alliances (working relationships) with stroke survivors, and their views on how alliance relates to self-management in community settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Healthcare professionals recruited purposively from four National Health Service community stroke teams in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main measures<\/jats:title>\n                    <jats:p>Semi-structured, one-to-one qualitative interviews, transcribed verbatim and analysed using Braun and Clarke's reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen clinicians (six physiotherapists, four occupational therapists, two speech and language therapists, two nurses, one psychologist and four people in assistant\/trainee roles) were included in the study. Three main themes were developed from the data. (1)\n                      <jats:italic>The team can\u2019t come forever<\/jats:italic>\n                      : alliances were shaped by the time-limited nature of community rehabilitation and relied on trust, buy-in, and clearly defined roles and expectations. (2)\n                      <jats:italic>Therapeutic alliances help and hinder<\/jats:italic>\n                      : whilst alliances supported motivation and engagement, complicated power dynamics sometimes undermined self-management. (3)\n                      <jats:italic>Confusion about what self-management is<\/jats:italic>\n                      : participants often equated self-management with self-directed rehabilitation and described a lack of clarity, confidence and training in supporting emotional and long-term adjustment needs. Strong alliances were viewed as essential for self-management, but formal support strategies were rarely used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Community-based healthcare professionals consider therapeutic alliance to be the foundation for stroke self-management in the community. However, a limited understanding of self-management among clinicians, combined with unbalanced power dynamics, may restrict patient autonomy. Relationship-based training (e.g. Bridges) and the development of self-management champion roles within organisations may enhance clinicians\u2019 confidence and consistency in delivering self-management support in the community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155251358457","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T09:21:12Z","timestamp":1753089672000},"page":"1254-1265","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["How important are working relationships for stroke self-management? A qualitative study with healthcare professionals in community stroke teams"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6650-9139","authenticated-orcid":false,"given":"Lauren","family":"Lucas","sequence":"first","affiliation":[{"name":"Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK"},{"name":"Northern Care Alliance NHS Trust, Greater Manchester, UK"},{"name":"Geoffrey Jefferson Brain Research Centre &amp; The Manchester Academic Health Science Centre, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Peters","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5136-390X","authenticated-orcid":false,"given":"Sarah","family":"Cotterill","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4075-1215","authenticated-orcid":false,"given":"Audrey","family":"Bowen","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK"},{"name":"Geoffrey Jefferson Brain Research Centre &amp; The Manchester Academic Health Science Centre, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"National Clinical Guideline for Stroke for the UK and Ireland https:\/\/ www.strokeguideline.org (2023 accessed 18 October 2023)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2008.12.011"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9040985"},{"key":"e_1_3_3_5_2","volume-title":"Unending work and care: managing chronic illness at home","author":"Corbin JM","year":"1988","unstructured":"Corbin JM, Strauss A. 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