Department of Biomedical and Neuromotor Sciences, Section of Hygiene and Biostatistics, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, Section of Hygiene and Biostatistics, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Patient Educ Couns. 2020 Jun;103(6):1191-1200. doi: 10.1016/j.pec.2020.01.004. Epub 2020 Jan 20.
To test the efficacy of a self-management intervention for stroke survivors vs. usual care.
Using a quasi-experimental study, participants were recruited from three public Italian hospitals. Questionnaires assessing self-efficacy (SSEQ), quality of life (SF-12), physical performance (SPPB), depression (GDS) and activities of daily living (MBI) were administered at baseline, discharge and two months after discharge. Mixed models with a propensity score were used between experimental group (EG) and control group (CG). Logistic models were used to compare the use of health services.
Eighty-two stroke survivors were enrolled in the EG and 103 in the CG. Self-efficacy in self-management improved in the EG compared to the CG during hospitalization. Improvements from baseline to discharge were found in the EG in the mental component of SF-12 and in MBI. The EG were 8.9 times more likely to contact general practitioners after discharge and 2.9 times to do regular exercise than CG. Notably, EG with higher education benefitted more from the intervention.
The intervention was efficacious in improving self-efficacy, mental health and activities of daily living.
Structured educational interventions based on problem-solving and individual goal setting may improve self-management skills in stroke survivors.
测试针对中风幸存者的自我管理干预措施相对于常规护理的疗效。
采用准实验研究，从意大利的三家公立医院招募参与者。在基线、出院时和出院后两个月时使用自我效能感评估量表（SSEQ）、生活质量量表（SF-12）、身体表现量表（SPPB）、抑郁量表（GDS）和日常生活活动量表（MBI）对参与者进行评估。使用倾向评分混合模型对实验组（EG）和对照组（CG）进行比较。使用逻辑模型比较卫生服务的使用情况。
共有 82 名中风幸存者被纳入实验组，103 名被纳入对照组。与对照组相比，实验组在住院期间的自我管理自我效能感有所提高。实验组在出院时的 SF-12 精神成分和 MBI 方面均较基线有所改善。与对照组相比，实验组在出院后更有可能联系全科医生，且更有可能定期锻炼。值得注意的是，接受过高等教育的实验组从干预中获益更多。
干预措施在提高自我效能感、心理健康和日常生活活动能力方面是有效的。
基于解决问题和个人目标设定的结构化教育干预措施可能会提高中风幸存者的自我管理技能。
