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Current stroke rehabilitation tends to focus on the bio-medical course of disability, often responding to psychological and social issues only when they have been implicated in crises. Although this situation is costly, little evidence exists in relation to how psychological and social outcomes can be facilitated or how psychosocial decline can be prevented. In the area of adjustment following traumatic injury, there has been some suggestion that rehabilitation should focus on the expansion of resources, skills and self-efficacy as this will enable individuals to cope more effectively with their medical condition and circumstances. The current study was a longitudinal randomised controlled trial involving 100 people with stroke, 58 of whom were randomly allocated to an intervention based on the notion of psychosocial skill expansion. All were patients of a major hospital in Queensland, Australia. An existing self-management intervention (The Chronic Disease Self-Management Course, Lorig et al., 2001) was used to operationalise the concept of psychosocial skill expansion. The control group reported declines in functioning during the first year following stroke in the areas of family roles, activities of daily living, self-care and work productivity, that were not reported by the intervention group. Although the groups had reached similar levels by one year post-stroke, this intervention may have a protective function, presumably by improving capacity to manage the functional requirements of daily life. However, the intervention did not appear to have its impact through self-efficacy, as was expected, and failed to influence outcomes such as mood or social participation. Nevertheless, the intervention warrants further investigation, given that it appears to improve rehabilitation outcomes, at least in the short-term. Keywords: Self-management education; Self-efficacy; Stroke recovery; Rehabilitation; Australia

Community-based research (CBR) refers to an applied research methodology that is conducted in community settings in partnership between academic and nonacademic participants in research. This article reports on a series of in-depth interviews conducted with 11 Australian CBR researchers between 2008 and 2009. The interviews were designed to explore whether university-employed CBR researchers experience the particular phenomenon of 'moral distress,' or feelings of helplessness to act in accordance with one's moral values due to systemic or institutional constraints. Study results found that the CBR researchers experienced unavoidable moral distress at varying levels of intensity related to blurred boundaries between settings, participants, and stakeholders. Based on the outcomes of this study, further research and enhanced professional development and training practices are recommended. [ABSTRACT FROM AUTHOR]