Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial

Janet WH Sit,1 Sek Ying Chair,1 Kai Chow Choi,1 Carmen WH Chan,1 Diana TF Lee,1 Aileen WK Chan,1 Jo LK Cheung,1 Siu Wai Tang,2 Po Shan Chan,2 Ruth E Taylor-Piliae3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, 2Department of Medicine and Rehabilita...

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Autores principales:	Sit JW, Chair SY, Choi KC, Chan CW, Lee DT, Chan AW, Cheung JL, Tang SW, Chan PS, Taylor-Piliae RE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	self-management patient empowerment stroke rehabilitation self-efficacy clinical trial Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/ef4a16e07d55477fbca0e21a01a54c90
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spelling	oai:doaj.org-article:ef4a16e07d55477fbca0e21a01a54c902021-12-02T03:44:42ZDo empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial1178-1998https://doaj.org/article/ef4a16e07d55477fbca0e21a01a54c902016-10-01T00:00:00Zhttps://www.dovepress.com/do-empowered-stroke-patients-perform-better-at-self-management-and-fun-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Janet WH Sit,1 Sek Ying Chair,1 Kai Chow Choi,1 Carmen WH Chan,1 Diana TF Lee,1 Aileen WK Chan,1 Jo LK Cheung,1 Siu Wai Tang,2 Po Shan Chan,2 Ruth E Taylor-Piliae3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, 2Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital, Hong Kong Hospital Authority, Causeway Bay, Hong Kong, People’s Republic of China; 3College of Nursing, The University of Arizona, Tucson, AZ, USA Background: Self-management after a stroke is a challenge because of multifaceted care needs and complex disabling consequences that cause further hindrance to patient participation. A 13-week stroke patient empowerment intervention (Health Empowerment Intervention for Stroke Self-management [HEISS]) was developed to enhance patients’ ability to participate in self-management.Purpose: To examine the effects of the empowerment intervention on stroke patients’ self-efficacy, self-management behavior, and functional recovery.Methods: This is a single-blind randomized controlled trial with stroke survivors assigned to either a control group (CG) receiving usual ambulatory rehabilitation care or the HEISS in addition to usual care (intervention group [IG]). Outcome data were collected at baseline (T0), 1 week (T1), 3 months (T2), and 6 months (T3) postintervention. Data were analyzed on the intention-to-treat principle. The generalized estimating equation model was used to assess the differential change of self-efficacy in illness management, self-management behaviors (cognitive symptom management, communication with physician, medication adherence, and self-blood pressure monitoring), and functional recovery (Barthel and Lawton indices) across time points (baseline = T0, 1 week = T1, 3 months = T2, and 6 months = T3 postintervention) between the two groups.Results: A total of 210 (CG =105, IG =105) Hong Kong Chinese stroke survivors (mean age =69 years, 49% women, 72% ischemic stroke, 89% hemiparesis, and 63% tactile sensory deficit) were enrolled in the study. Those in IG reported better self-efficacy in illness management 3-month (P=0.011) and 6-month (P=0.012) postintervention, along with better self-management behaviors at all follow-up time points (all P<0.05), apart from medication adherence (P>0.05). Those in IG had significantly better functional recovery (Barthel, all P<0.05; Lawton, all P<0.001), compared to CG. The overall dropout rate was 16.7%.Conclusion: Patient empowerment intervention (HEISS) may influence self-efficacy in illness management and improve self-management behavior and functional recovery of stroke survivors. Furthermore, the HEISS can be conducted in parallel with existing ambulatory stroke rehabilitation services and provide added value in sustaining stroke self-management and functional improvement in the long term. Keywords: self-management, patient empowerment, stroke, rehabilitation, functional recovery, activities of daily living Sit JWChair SYChoi KCChan CWLee DTChan AWCheung JLTang SWChan PSTaylor-Piliae REDove Medical Pressarticleself-managementpatient empowermentstrokerehabilitationself-efficacyclinical trialGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1441-1450 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	self-management patient empowerment stroke rehabilitation self-efficacy clinical trial Geriatrics RC952-954.6
spellingShingle	self-management patient empowerment stroke rehabilitation self-efficacy clinical trial Geriatrics RC952-954.6 Sit JW Chair SY Choi KC Chan CW Lee DT Chan AW Cheung JL Tang SW Chan PS Taylor-Piliae RE Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
description	Janet WH Sit,1 Sek Ying Chair,1 Kai Chow Choi,1 Carmen WH Chan,1 Diana TF Lee,1 Aileen WK Chan,1 Jo LK Cheung,1 Siu Wai Tang,2 Po Shan Chan,2 Ruth E Taylor-Piliae3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, 2Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital, Hong Kong Hospital Authority, Causeway Bay, Hong Kong, People’s Republic of China; 3College of Nursing, The University of Arizona, Tucson, AZ, USA Background: Self-management after a stroke is a challenge because of multifaceted care needs and complex disabling consequences that cause further hindrance to patient participation. A 13-week stroke patient empowerment intervention (Health Empowerment Intervention for Stroke Self-management [HEISS]) was developed to enhance patients’ ability to participate in self-management.Purpose: To examine the effects of the empowerment intervention on stroke patients’ self-efficacy, self-management behavior, and functional recovery.Methods: This is a single-blind randomized controlled trial with stroke survivors assigned to either a control group (CG) receiving usual ambulatory rehabilitation care or the HEISS in addition to usual care (intervention group [IG]). Outcome data were collected at baseline (T0), 1 week (T1), 3 months (T2), and 6 months (T3) postintervention. Data were analyzed on the intention-to-treat principle. The generalized estimating equation model was used to assess the differential change of self-efficacy in illness management, self-management behaviors (cognitive symptom management, communication with physician, medication adherence, and self-blood pressure monitoring), and functional recovery (Barthel and Lawton indices) across time points (baseline = T0, 1 week = T1, 3 months = T2, and 6 months = T3 postintervention) between the two groups.Results: A total of 210 (CG =105, IG =105) Hong Kong Chinese stroke survivors (mean age =69 years, 49% women, 72% ischemic stroke, 89% hemiparesis, and 63% tactile sensory deficit) were enrolled in the study. Those in IG reported better self-efficacy in illness management 3-month (P=0.011) and 6-month (P=0.012) postintervention, along with better self-management behaviors at all follow-up time points (all P<0.05), apart from medication adherence (P>0.05). Those in IG had significantly better functional recovery (Barthel, all P<0.05; Lawton, all P<0.001), compared to CG. The overall dropout rate was 16.7%.Conclusion: Patient empowerment intervention (HEISS) may influence self-efficacy in illness management and improve self-management behavior and functional recovery of stroke survivors. Furthermore, the HEISS can be conducted in parallel with existing ambulatory stroke rehabilitation services and provide added value in sustaining stroke self-management and functional improvement in the long term. Keywords: self-management, patient empowerment, stroke, rehabilitation, functional recovery, activities of daily living
format	article
author	Sit JW Chair SY Choi KC Chan CW Lee DT Chan AW Cheung JL Tang SW Chan PS Taylor-Piliae RE
author_facet	Sit JW Chair SY Choi KC Chan CW Lee DT Chan AW Cheung JL Tang SW Chan PS Taylor-Piliae RE
author_sort	Sit JW
title	Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
title_short	Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
title_full	Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
title_fullStr	Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
title_full_unstemmed	Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial
title_sort	do empowered stroke patients perform better at self-management and functional recovery after a stroke? a randomized controlled trial
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/ef4a16e07d55477fbca0e21a01a54c90
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Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial

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