Kate Mahesh Pundlik, Verma Shweta Jain, Arora Deepti, Sylaja P N, Padma M V, Bhatia Rohit, Khurana Dheeraj, Sharma Arvind, Ojha Pawan Kumar, Renjith Vishnu, Kulkarni Girish Baburao, Sadiq Mohammad, Jabeen S, Borah N C, Ray Biman Kanti, Sharma Meenakshi, Pandian Jeyaraj Durai
Department of Clinical Neurosciences, Alberta Health Services, Edmonton, Canada.
Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.
Ann Indian Acad Neurol. 2020 Sep-Oct;23(5):681-686. doi: 10.4103/aian.AIAN_639_19. Epub 2020 Oct 7.
Lack of compliance to medication and uncontrolled risk factors are associated with increased risk of recurrent stroke and acute coronary syndrome in patients with recent stroke. Multimodal patient education may be a strategy to improve the compliance to medication and early adoption of nonpharmacological measures to reduce the vascular risk factor burden in patients with stroke. We thus aim to develop multilingual short messaging services (SMS), print, and audio-visual secondary stroke prevention patient education package. The efficacy of the package will be tested in a randomized control trial to prevent major cardiovascular and cerebrovascular events.
In the stage, intervention materials (SMS, video, and workbook) were developed. In the stage, the package was independently assessed and modified by the stakeholders involved in the stroke patient care and local language experts. The modified stroke prevention package was tested for implementation issues ( stage).
Sixty-nine SMS, six videos, and workbook with 11 chapters with 15 activities were developed in English language with a mean ± SD SMOG index of 9.1 ± 0.4. A total of 355 stakeholders including patients (24.8%), caregivers (24.8%), doctors (10.4%), nurses (14.1%), local language experts (2.8%), physiotherapists (13.2%), and research coordinators (9.8%) participated in 10 acceptability stage meetings. The mean Patient Education Material Assessment Tool understandability score in all languages for SMS, video scripts, and workbook was 95.2 ± 2.6%, 95.2 ± 4.4%, and 95.3 ± 3.6%, respectively. The patients [ = 20, mean age of 70.3 ± 10.6 years and median interquartile range (IQR) baseline NIHSS 1 (0-3)] or the research coordinators ( = 2) noted no implementation issues at the end of 1 month.
An implementable complex multilingual patient education material could be developed in a stepwise manner. The efficacy of the package to prevent major adverse cardiovascular events is being tested in the SPRINT INDIA study.
近期中风患者中，不遵医嘱服药以及危险因素控制不佳与复发性中风和急性冠状动脉综合征风险增加相关。多模式患者教育可能是一种提高服药依从性并尽早采用非药物措施以减轻中风患者血管危险因素负担的策略。因此，我们旨在开发多语言短信服务（SMS）、印刷品和视听二次中风预防患者教育包。该教育包的疗效将在一项随机对照试验中进行测试，以预防重大心血管和脑血管事件。
在第一阶段，开发了干预材料（短信、视频和工作手册）。在第二阶段，由参与中风患者护理的利益相关者和当地语言专家对该教育包进行独立评估和修改。对修改后的中风预防教育包进行实施问题测试（第三阶段）。
用英语开发了69条短信、6个视频和一本包含11章15项活动的工作手册，平均±标准差的雾指数为9.1±0.4。包括患者（24.8%）、护理人员（24.8%）、医生（10.4%）、护士（14.1%）、当地语言专家（2.8%）、物理治疗师（13.2%）和研究协调员（9.8%）在内的355名利益相关者参加了10次可接受性阶段会议。短信、视频脚本和工作手册在所有语言中的患者教育材料评估工具平均可理解性得分分别为95.2±2.6%、95.2±4.4%和95.3±3.6%。患者组[ = 20，平均年龄70.3±10.6岁，基线美国国立卫生研究院卒中量表（NIHSS）中位数四分位间距（IQR）为1（0 - 3）]或研究协调员（ = 2）在1个月末未发现实施问题。
可以逐步开发出可实施的复杂多语言患者教育材料。该教育包预防重大不良心血管事件的疗效正在印度SPRINT研究中进行测试。
