Developing workable research methods: Lessons from a pilot study with vulnerable participants and complex assessments

Following acute stroke, deterioration in nutritional status and weight loss is common; few studies have investigated this, perhaps due to difficulties with recruitment and completion of complex assessments with stroke patients. This study reports the feasibility of a study protocol to determine predictors of nutritional intake in stroke patients. The aim of the study was to test the feasibility of a protocol to measure taste and smell function, and explore links with dietary intake following stroke. Patients were recruited from one Acute Stroke Unit in 2007/8. Data were collected at three time-points and entailed standardised validated assessments of taste and smell function, diet, appetite and mood state. Recruitment of this vulnerable population to a demanding assessment schedule was challenging. Of a cohort of 166 admissions, six were recruited and complete data collected from four participants. Slow recruitment was largely due to exacting inclusion criteria and rapid hospital discharge. Those who completed all assessments reported the schedule as tolerable and acceptable. This study illustrated the difficulties of recruiting this vulnerable population. Identification of reasons for slow recruitment facilitated development of measures to address them. It was possible to format a complex and lengthy assessment schedule to be acceptable to vulnerable participants.