Stroke Self-Management Support Improves Survivors' Self-Efficacy and Outcome Expectation of Self-Management Behaviors

Abstract

Background and purpose: Evidence shows self-management programs are associated with improved recovery outcomes. This article reports on the effectiveness of a new nurse-led self-efficacy-based stroke self-management program.

Methods: A randomized controlled trial of participants recruited from 3 acute stroke units was conducted. The intervention group received the 4-week stroke self-management program. The control group received usual care. All participants were assessed at baseline and 8 weeks after randomization. Data were analyzed using generalized estimating equations. Outcomes included self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors.

Results: One hundred twenty-eight participants were randomized with mean age, 67.46 years (SD, 11.95); 59% men; and mean duration poststroke, 45 days (SD, 26.16). At 8 weeks of follow-up in the intention-to-treat population, the intervention group improved significantly in self-efficacy (95% confidence interval, 2.55-12.45; P<0.01), outcome expectation (95% confidence interval, 5.47-14.01; P<0.01), and satisfaction with performance of self-management behaviors (95% confidence interval, 3.38-13.87; P<0.01) compared with the control. Similar results were obtained at 8 weeks of follow-up in the per-protocol population.

Conclusions: The stroke self-management program improved survivors' self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02112955.

Keywords: follow-up studies; randomized controlled trial; residence characteristics; self-efficacy; self-management; stroke.