Tielemans Nienke S, Visser-Meily Johanna M A, Schepers Vera P M, van de Passier Patricia E, Port Ingrid G L, Vloothuis Judith D M, Struyf Pieter A A, van Heugten Caroline M
School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Rehabil Med. 2015 Nov;47(10):901-9. doi: 10.2340/16501977-2020.
To investigate the effectiveness of a self-management intervention aimed at proactive coping for stroke patients and partners, compared with an education intervention.
Multicentre randomized controlled trial.
The study included 113 stroke patients (mean age 57.0 years (standard deviation (SD) 9.0), mean 18.8 months after stroke (SD 28.4)) and 57 partners (mean age 59.2 years (SD 8.3)).
Participants were randomized to a self-management intervention, or an education intervention, both 10 weeks' duration, outpatient, stroke-specific, and group-based. Main patient inclusion criteria were symptomatic stroke (≥ 6 weeks previously) and reporting ≥ 2 restrictions on the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation Participation. Measurements were performed immediately after intervention, and at 3 and 9 months follow-up. Primary patient and partner outcomes were proactive coping and participation restrictions. Analyses were based on linear mixed modelling.
A significant effect was found only in partners' increased proactive coping at T2 (compared with education intervention). Beneficial trends were found for the self-manage-ment intervention in partners' self-efficacy and patients' health-related quality of life, mood complaints and participation restriction.
Little convincing evidence was found favouring our self-management intervention over the education intervention; therefore, the self-management intervention should not be implemented yet in clinical practice. Further research is needed to explore beneficial trends.
与教育干预相比，调查一项旨在帮助中风患者及其伴侣进行积极应对的自我管理干预措施的有效性。
多中心随机对照试验。
该研究纳入了113名中风患者（平均年龄57.0岁（标准差（SD）9.0），中风后平均18.8个月（SD 28.4））和57名伴侣（平均年龄59.2岁（SD 8.3））。
参与者被随机分为自我管理干预组或教育干预组，两种干预均为期10周，为门诊、针对中风且基于小组的干预。主要患者纳入标准为有症状性中风（≥6周前）且在乌得勒支康复参与评估量表的限制子量表上报告有≥2项限制。在干预结束后立即以及在3个月和9个月随访时进行测量。主要患者和伴侣结局为积极应对和参与限制。分析基于线性混合模型。
仅在伴侣在T2时积极应对增加方面发现了显著效果（与教育干预相比）。在伴侣的自我效能、患者与健康相关的生活质量、情绪主诉和参与限制方面，自我管理干预发现了有益趋势。
几乎没有令人信服的证据表明我们的自我管理干预优于教育干预；因此，自我管理干预目前不应在临床实践中实施。需要进一步研究以探索有益趋势。
