Olaiya Muideen T, Cadilhac Dominique A, Kim Joosup, Ung David, Nelson Mark R, Srikanth Velandai K, Bladin Christopher F, Gerraty Richard P, Fitzgerald Sharyn M, Phan Thanh, Frayne Judith, Thrift Amanda G
From the Departments of Medicine (M.T.O., D.A.C., J.K., D.U., V.K.S., T.P., A.G.T.) and Epidemiology and Preventive Medicine (M.R.N., S.M.F.), Monash University, Melbourne, VIC, Australia; Stroke Division, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia (D.A.C., J.K.); Menzies Institute for Medical Research, Hobart, TAS, Australia (M.R.N., V.K.S.); Department of Neurosciences, Box Hill Hospital, VIC, Australia (C.F.B.); Department of Medicine, Epworth Healthcare, Richmond, VIC, Australia (R.P.G.); and Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia (J.F.).
Stroke. 2017 Apr;48(4):1101-1103. doi: 10.1161/STROKEAHA.116.016229. Epub 2017 Mar 1.
Despite the benefit of risk awareness in secondary prevention, survivors of stroke are often unaware of their risk factors. We determined whether a nurse-led intervention improved knowledge of risk factors in people with stroke or transient ischemic attack.
Prospective study nested within a randomized controlled trial of risk factor management in survivors of stroke or transient ischemic attack.
3 nurse education visits and specialist review of care plans.
unprompted knowledge of risk factors of stroke or transient ischemic attack at 24 months. Effect of intervention on knowledge and factors associated with knowledge were determined using multivariable regression models.
Knowledge was assessed in 268 consecutive participants from the main trial, 128 in usual care and 140 in the intervention. Overall, 34% of participants were unable to name any risk factor. In adjusted analyses, the intervention group had better overall knowledge than controls (incidence risk ratio, 1.26; 95% confidence interval, 1.00-1.58). Greater functional ability and polypharmacy were associated with better knowledge and older age and having more comorbidities associated with poorer knowledge.
Overall knowledge of risk factors of stroke or transient ischemic attack was better in the intervention group than controls. However, knowledge was generally poor. New and more effective strategies are required, especially in subgroups identified as having poor knowledge.
URL: http://www.anzctr.org.au. Unique identifier: ACTRN12608000166370.
尽管风险意识对二级预防有益，但中风幸存者往往未意识到自身的风险因素。我们确定了由护士主导的干预措施是否能提高中风或短暂性脑缺血发作患者对风险因素的认知。
在一项针对中风或短暂性脑缺血发作幸存者的风险因素管理随机对照试验中进行的前瞻性研究。
3次护士教育访视及对护理计划的专家审查。
24个月时对中风或短暂性脑缺血发作风险因素的自发认知。使用多变量回归模型确定干预措施对认知及与认知相关因素的影响。
对主要试验中的268名连续参与者进行了认知评估，其中128名接受常规护理，140名接受干预。总体而言，34%的参与者无法说出任何风险因素。在调整分析中，干预组的总体认知优于对照组（发病率风险比为1.26；95%置信区间为1.00 - 1.58）。功能能力更强和使用多种药物与更好的认知相关，而年龄较大和合并症较多与较差的认知相关。
干预组对中风或短暂性脑缺血发作风险因素的总体认知优于对照组。然而，总体认知普遍较差。需要新的、更有效的策略，尤其是在被确定为认知较差的亚组中。
