Appalasamy Jamuna Rani, Joseph Joyce Pauline, Seeta Ramaiah Siva, Md Zain Anuar Zaini, Quek Kia Fatt, Tha Kyi Kyi
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
JMIR Aging. 2020 Jul 10;3(2):e17182. doi: 10.2196/17182.
A large number of stroke survivors worldwide suffer from moderate to severe disability. In Malaysia, long-term uncontrolled stroke risk factors lead to unforeseen rates of recurrent stroke and a growing incidence of stroke occurrence across ages, predominantly among the elderly population. This situation has motivated research efforts focused on tapping into patient education, especially related to patient self-efficacy of understanding and taking medication appropriately. Video narratives integrated with health belief model constructs have demonstrated potential impacts as an aide to patient education efforts.
The aim of this study was to investigate the feasibility and acceptability of study procedures based on a randomized controlled trial protocol of a video narratives intervention among poststroke patients. We also aimed to obtain preliminary findings of video narratives related to medication understanding and use self-efficacy (MUSE) and blood pressure control.
A parallel group randomized controlled trial including a control group (without video viewing) and an intervention group (with video viewing) was conducted by researchers at a neurology outpatient clinic on poststroke patients (N=54). Baseline data included patients' sociodemographic characteristics, medical information, and all outcome measures. Measurements of MUSE and blood pressure following the trial were taken during a 3-month follow-up period. Feasibility of the trial was assessed based on recruitment and study completion rates along with patients' feedback on the burden of the study procedures and outcome measures. Acceptability of the trial was analyzed qualitatively. Statistical analysis was applied to ascertain the preliminary results of video narratives.
The recruitment rate was 60 out of 117 patients (51.3%). Nevertheless, the dropout rate of 10% was within the acceptable range. Patients were aged between 21 and 74 years. Nearly 50 of the patients (>85%) had adequate health literacy and exposure to stroke education. Most of the patients (>80%) were diagnosed with ischemic stroke, whereby the majority had primary hypertension. The technicalities of randomization and patient approach were carried out with minimal challenge and adequate patient satisfaction. The video contents received good responses with respect to comprehension and simplicity. Moreover, an in-depth phone interview with 8 patients indicated that the video narratives were considered to be useful and inspiring. These findings paralleled the preliminary findings of significant improvement within groups in MUSE (P=.001) and systolic blood pressure control (P=.04).
The queries and feedback from each phase in this study have been acknowledged and will be taken forward in the full trial.
Australian New Zealand Clinical Trials Registry ACTRN 12618000174280; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373554.
全球大量中风幸存者患有中度至重度残疾。在马来西亚，长期未得到控制的中风风险因素导致复发性中风发生率意外上升，且各年龄段中风发病率不断增加，主要发生在老年人群中。这种情况促使研究工作聚焦于开展患者教育，特别是与患者正确理解和服用药物的自我效能相关的教育。结合健康信念模型构建的视频叙事已证明作为患者教育辅助手段具有潜在影响。
本研究旨在调查基于中风后患者视频叙事干预随机对照试验方案的研究程序的可行性和可接受性。我们还旨在获得与药物理解和使用自我效能（MUSE）以及血压控制相关的视频叙事的初步结果。
一家神经病学门诊诊所的研究人员对中风后患者（N = 54）进行了一项平行组随机对照试验，包括一个对照组（不观看视频）和一个干预组（观看视频）。基线数据包括患者的社会人口学特征、医疗信息和所有结局指标。试验后在3个月的随访期内对MUSE和血压进行测量。根据招募率和研究完成率以及患者对研究程序和结局指标负担的反馈来评估试验的可行性。对试验的可接受性进行定性分析。应用统计分析来确定视频叙事的初步结果。
117名患者中有60名被招募（51.3%）。然而，10%的失访率在可接受范围内。患者年龄在21岁至74岁之间。近50名患者（>85%）具备足够的健康素养且接受过中风教育。大多数患者（>80%）被诊断为缺血性中风，其中大多数患有原发性高血压。随机分组和接触患者的技术实施起来挑战最小，患者满意度较高。视频内容在理解性和简易性方面得到了良好反馈。此外，对8名患者进行的深入电话访谈表明，视频叙事被认为是有用且鼓舞人心的。这些发现与组内MUSE（P = .001）和收缩压控制（P = .04）显著改善的初步结果相符。
本研究各阶段的疑问和反馈已得到确认，并将在全面试验中继续推进。
澳大利亚新西兰临床试验注册中心ACTRN 12618000174280；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373554。
