Appalasamy Jamuna Rani, Tha Kyi Kyi, Quek Kia Fatt, Ramaiah Siva Seeta, Joseph Joyce Pauline, Md Zain Anuar Zaini
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia Subang Jaya Medical Centre, Jalan SS12/1a, Selangor Neurology Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Medicine (Baltimore). 2018 Jun;97(22):e10876. doi: 10.1097/MD.0000000000010876.
A substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy. Nevertheless, only a handful of studies have probed into the effectiveness of video narrative at stroke care centers.
This is a behavioral randomized controlled trial of patient education intervention with video narratives for patients with stroke lacking medication understanding and use self-efficacy. The study will recruit up to 200 eligible stroke patients at the neurology tertiary outpatient clinic, whereby they will be requested to return for follow-up approximately 3 months once for up to 12 months. Consenting patients will be randomized to either standard patient education care or intervention with video narratives. The researchers will ensure control of potential confounding factors, as well as unbiased treatment review with prescribed medications only obtained onsite.
The primary analysis outcomes will reflect the variances in medication understanding and use self-efficacy scores, as well as the associated factors, such as retention of knowledge, belief and perception changes, whereas stroke risk factor control, for example, self-monitoring and quality of life, will be the secondary outcomes.
The study should be able to determine if video narrative can induce a positive behavioral change towards stroke risk factor control via enhanced medication understanding and use self-efficacy. This intervention is innovative as it combines health belief, motivation, and role model concept to trigger self-efficacy in maintaining healthy behaviors and better disease management.
ACTRN (12618000174280).
世界上相当一部分人口在中风后似乎会出现中度至重度的长期残疾。持续未得到控制的中风风险因素会导致不可预测的复发性中风事件。马来西亚各年龄段中风患病率的上升促使了药物治疗依从性诊所（MTAC）框架的采用。中风护理单元的患者教育资源有限，尤其是在药物理解和自我效能使用方面。然而，只有少数研究探讨了中风护理中心视频叙事的有效性。
这是一项针对缺乏药物理解和自我效能使用的中风患者进行视频叙事患者教育干预的行为随机对照试验。该研究将在神经科三级门诊招募多达200名符合条件的中风患者，要求他们在长达12个月的时间里每3个月左右回来进行一次随访。同意参与的患者将被随机分为接受标准患者教育护理或视频叙事干预。研究人员将确保控制潜在的混杂因素，并仅在现场获取的处方药进行无偏倚的治疗审查。
主要分析结果将反映药物理解和自我效能得分的差异以及相关因素，如知识保留、信念和认知变化，而中风风险因素控制，如自我监测和生活质量，将是次要结果。
该研究应该能够确定视频叙事是否可以通过增强药物理解和自我效能使用来诱导对中风风险因素控制的积极行为改变。这种干预具有创新性，因为它结合了健康信念、动机和榜样概念，以激发自我效能来维持健康行为和更好地管理疾病。
ACTRN（12618000174280）。
