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一种促进卒中后健康生活方式的远程医疗干预:卒中教练方案。

A telehealth intervention to promote healthy lifestyles after stroke: The Stroke Coach protocol.

机构信息

1 Department of Physical Therapy, 8166 University of British Columbia , Vancouver, Canada.

2 Faculty of Health Sciences, 1763 Simon Fraser University , Burnaby, Canada.

出版信息

Int J Stroke. 2018 Feb;13(2):217-222. doi: 10.1177/1747493017729266. Epub 2017 Sep 4.

Abstract

Rationale Recurrent stroke is prevalent and associated with high mortality rates, disability, and social and economic costs. Adequate management of risk factors may reduce recurrent stroke; however, many stroke survivors have poor control of risk factors. We have developed a theoretically sound and evidence-based lifestyle modification program called the Stroke Coach, a telephone-based self-management program to improve control of risk factors. Hypothesis Individuals who participate in Stroke Coach will achieve more lifestyle improvements than individuals in an attention controlled Memory Training Program. Design In this single blind randomized controlled trial, 126 community-living stroke survivors will be randomized to Stroke Coach or the attention control group. Participants randomized to the six-month Stroke Coach will receive seven telephone lifestyle coaching sessions, self-management education and practice, and a self-monitoring kit, comprised of a health report card, with blood pressure and activity monitors. Study Outcomes The primary outcome will be measured using the Health Promoting Lifestyle Profile II. Secondary outcomes include behavioral and physiological risk factors, quality of life, cognitive status, health and social service use. Measurements will be taken at baseline, immediately after the intervention and six-month post-intervention. Summary The results of this trial will add to our understanding of the use of self-management to improve control of risk factors, and may facilitate the development of a larger trial evaluating the effect of Stroke Coach on endpoints such as recurrent stroke or cardiac events as the primary outcome.

摘要

背景

复发性卒中很常见,死亡率、残疾率以及社会和经济成本都很高。充分管理危险因素可能会降低复发性卒中的风险;然而,许多卒中幸存者对危险因素的控制不佳。我们开发了一种理论上合理且基于证据的生活方式改变计划,称为卒中教练,这是一种基于电话的自我管理计划,旨在改善危险因素的控制。

假设

与参加注意控制的记忆训练计划的个体相比,参加卒中教练的个体将实现更多的生活方式改善。

设计

在这项单盲随机对照试验中,将随机分配 126 名居住在社区的卒中幸存者至卒中教练组或注意控制组。随机分配至 6 个月卒中教练组的参与者将接受 7 次电话生活方式辅导,自我管理教育和实践,以及自我监测工具包,包括健康报告卡、血压和活动监测器。

研究结果

主要结局将使用健康促进生活方式量表 II 进行测量。次要结局包括行为和生理危险因素、生活质量、认知状态、健康和社会服务使用。在基线、干预后即刻和干预后 6 个月进行测量。

总结

该试验的结果将有助于我们了解自我管理在改善危险因素控制方面的应用,并且可能有助于开展更大规模的试验,评估卒中教练对复发性卒中或心脏事件等主要结局的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2271/5770204/10d874fa0d0f/nihms7005f1.jpg

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