Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Oct 13:11:1441-1450.
doi: 10.2147/CIA.S109560. eCollection 2016.

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-Piliae  3
Affiliations
Randomized Controlled Trial

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

Janet Wh Sit et al. Clin Interv Aging. .

Abstract

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: activities of daily living; functional recovery; patient empowerment; rehabilitation; self-management; stroke.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of participant recruitment. Abbreviations: CG, control group; IG, intervention group.
See this image and copyright information in PMC

References

    1. WHO, editor. Global Status Health Report on Non-Communicable Diseases. Vol. 2011. Geneva: WHO; 2010.
    1. Hospital Authority [homepage on the Internet] HA Statistical Report. 2015. [Accessed February 1, 2016]. [updated 2015]. Available from: www.ha.org.hk.
    1. Jones F, Riazi A, Norris M. Self-management after stroke: time for some more questions? Disabil Rehabil. 2013;35(3):257–264. - PubMed
    1. Sit JW, Wong TK, Clinton M, Li LS. Associated factors of post-stroke depression among Hong Kong Chinese: a longitudinal study. Psychol Health Med. 2007;12(2):117–125. - PubMed
    1. Jones F. Strategies to enhance chronic disease self-management: how can we apply this to stroke? Disabil Rehabil. 2006;28(13–14):841–847. - PubMed

Publication types