The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
BMJ Open. 2019 May 1;9(4):e027936. doi: 10.1136/bmjopen-2018-027936.
Systematic reviews reporting self-management interventions are associated with significant improvements in stroke survivors' self-efficacy, health-related quality of life (HRQoL) and independence. However, common barriers such as transportation and availability of carers were identified. Health coaching is suggested as an innovative and cost-effective care model with potential benefits in managing chronic diseases. A randomised controlled trial is proposed to evaluate the effectiveness of an enhanced self-management programme by health coaches on stroke survivors' recovery outcomes.
All adult community-dwelling stroke survivors with a modified Rankin Scale Score ≥3 will be recruited from a community rehabilitation network. Eligible participants will be randomly allocated to receive either the enhanced stroke self-management programme (Coaching Ongoing Momentum Building On stroKe rEcovery journeY [COMBO-KEY]) plus usual care or usual care only. COMBO-KEY is an 8-week programme underpinned by Bandura's principles of self-efficacy and outcome expectation. It consists of four home visits and five phone-coaching sessions delivered by trained health coaches. Each participant will receive a resource package containing a workbook, a quick reference guide, a planning toolkit and 15 videos of peer survivors' stroke survival experience. Survivors' outcomes include self-efficacy, outcome expectation and satisfaction with performance of self-management behaviours, HRQoL, depressive symptoms and community reintegration. Assessment will be conducted at baseline and immediately after completing the programme. Generalised estimating equations' model will be used to analyse the data.
It is anticipated that the programme will build community capacity in supporting stroke survivors. The results will shed light on integrating the programme into the current stroke rehabilitation services.
The Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee has approved this protocol (CREC Ref. No.: 2018.009). Written informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals and presentations at local and international conferences.
ClinicalTrials.gov Identifier: NCT03741842; Pre-results.
系统评价报告自我管理干预与中风幸存者的自我效能、健康相关生活质量（HRQoL）和独立性显著提高有关。然而，也发现了一些常见障碍，如交通和护理人员的可用性。健康教练被认为是一种创新且具有成本效益的护理模式，在管理慢性病方面具有潜在的益处。本研究拟开展一项随机对照试验，评估健康教练增强的自我管理方案对中风幸存者康复结局的有效性。
所有居住在社区中的成年中风幸存者，改良 Rankin 量表评分≥3，将从社区康复网络中招募。符合条件的参与者将被随机分配接受增强型中风自我管理方案（Coaching Ongoing Momentum Building On stroKe rEcovery journeY [COMBO-KEY]）加常规护理或仅接受常规护理。COMBO-KEY 是一个 8 周的方案，基于班杜拉的自我效能和结果预期原则。它包括由经过培训的健康教练进行的四次家访和五次电话辅导。每位参与者将收到一个资源包，其中包含工作簿、快速参考指南、计划工具包和 15 个同行幸存者中风生存经验的视频。幸存者的结局包括自我效能、结果预期和对自我管理行为表现的满意度、HRQoL、抑郁症状和社区融合。评估将在基线时和完成方案后立即进行。将使用广义估计方程模型来分析数据。
预计该方案将提高社区支持中风幸存者的能力。研究结果将为将该方案纳入当前中风康复服务提供依据。
香港中文大学-新界东联网临床研究伦理委员会已批准该方案（CREC 编号：2018.009）。将从所有参与者处获得书面知情同意。研究结果将通过同行评议的期刊和在本地和国际会议上的报告进行传播。
ClinicalTrials.gov 标识符：NCT03741842；预注册。
