A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke

Abstract

Aim: The aim of this study was to determine the effectiveness of a community-based stroke prevention programme in (1) improving knowledge about stroke; (2) improving self-health-monitoring practice; (3) maintaining behavioural changes when adopting a healthy lifestyle for stroke prevention.

Background: People with minor stroke (or transient ischaemic attack) tend to under-estimate the long-term impact of this on their health. The challenge for nurses is to prevent subsequent strokes by finding ways to promote and sustain appropriate behaviours. Educational intervention is of paramount importance in equipping those at risk with relevant knowledge and self-care strategies for secondary stroke prevention.

Design: This study adopted a quasi-experimental design.

Method: One hundred and ninety subjects were recruited, of whom 147 (77 in the intervention group and 70 in the control group) completed the study. Data were obtained at three time points: baseline (T0); one week after (T1) and three months after (T2) the intervention. The intervention programme consisted of eight weekly two-hour sessions, with the aims of improving the participants' awareness of their own health signals and of actively involving them in self-care management of their own health for secondary stroke prevention.

Results: Significant positive changes were found among participants of the intervention group in the knowledge on stroke warning signs (P < 0.001); treatment seeking response in case of a stroke (P < 0.001); medication compliance (P < 0.001); self blood pressure monitoring (P < 0.001) as well as lifestyle modification of dietary habits (reduction in salted food intake, P = 0.004). No significant improvement was found in walking exercise participation in the intervention group, yet a significant decrease was detected among the control group.

Conclusion: This study found a three-month-sustained effect of positive changes in knowledge and skill from participants who undertook a nurse-led community-based stroke prevention programme.

Relevance to clinical practice: Effective educational intervention by professional nurses helped clients integrate their learned knowledge into their real-life practice. This empowering, that is, the taking of responsibility by clients for their own self-care management on a daily basis, affirms that patient education has moved beyond teaching people facts.