Co-designing narrative resources for implementation in lower limb amputation rehabilitation

Background: Narratives help people to make sense of illness and trauma experiences. Exposure to a breadth of narratives is proposed to offer validation, reassurance and support well-being. Previous research constructed five narratives from people with major lower limb amputation (MLLA). However, efforts to bridge the research-practice gap, and meet clinical priorities by translating the narratives into resources, remained. This study aimed to illustrate an immersive co-design process and develop narrative resources for healthcare professionals working within, and people undergoing MLLA rehabilitation. Methods: Commissioned by a National Health Service (NHS) MLLA rehabilitation centre, a 27-month rigorous co-design process was undertaken. An immersive, iterative three-stage process involving multiple end-user groups (e.g., patients, therapists, managers) and co-design activities (e.g., immersion, workshops) was used. Results: Two co-design workstreams were undertaken, one to develop resources for people with MLLA and one for new allied healthcare professionals (AHPs). Outcomes included perceptions of the narratives (e.g., authentic, awareness raising), content and format priorities (e.g., visual, novel), and factors likely to influence implementation and engagement (e.g., readiness, existing knowledge). Conclusions: Two narrative resource packages were co-designed for use in MLLA rehabilitation. The importance of context, and the dilemmas of sharing regressive narratives in clinical practice are discussed.