Longitudinal Study of Effectiveness of a Patient-Centered Self-Management Empowerment Intervention During Predischarge Planning on Stroke Survivors

Abstract

Purpose: To examine the effectiveness of a patient-centered self-management empowerment intervention (PCSMEI) on self-efficacy, activities of daily living (ADL), and rehospitalization of first-time stroke survivors.

Methods: One hundred forty-four first-time stroke survivors were recruited from a comprehensive hospital in China. The intervention group (IG; n = 72) received a PCSMEI, whereas the control group (CG; n = 72) received routine care. The data on self-efficacy and ADL were collected at baseline (T0), on discharge (T1), 1-month postdischarge (T2), and 3 months postdischarge (T3) while the rehospitalization was collected at T2 and T3. The general estimation equations model was used to examine the effects of the PCSMEI program on the outcome variables.

Results: One hundred twenty-six participants finished the study (IG: n = 64; CG: n = 62). Compared with the CG, patients in the IG showed significant higher level in self-efficacy on discharge (p = .014), 1-month postdischarge (p = .008), and 3 months postdischarge (p = .023), and higher level in ADL at 3 months postdischarge (p = .044). The rehospitalization rate of the IG was lower than that in the CG at 1-month postdischarge and 3 months postdischarge, which had clinical significance.

Linking evidence to action: PCSMEI is of great value to stroke patients. This paper forms the basis for more widespread implementation of PCSMEI.

Keywords: empowerment; patient-centered; pre-discharge planning; self-management; stroke.