The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.
New Territories East Cluster, Hospital Authority, Hong Kong SAR (Former).
Ann Behav Med. 2023 Sep 13;57(10):866-876. doi: 10.1093/abm/kaad028.
Multiple systematic reviews have reported that self-management interventions are associated with positive impacts on self-efficacy and health-related quality of life (HRQoL) of people with stroke.
This article reports the effects of an enhanced stroke self-management program.
Eligible adults with stroke were recruited from community-based organizations and a support group for a two-arm, assessor-blinded randomized controlled trial. Participants in the control group received usual care, while those in the intervention group also received the 8-week self-management program, Coaching Ongoing Momentum Building On stroKe rEcovery journeY (COMBO-KEY), consisting of four individual home visits and five follow-up phone calls, delivered by healthcare professionals and trained volunteers. Assessments were conducted at baseline and after the intervention, for outcomes of self-efficacy, satisfaction with the performance of self-management behaviors, HRQoL, and community reintegration, which were analyzed using generalized estimating equations (GEEs).
134 Participants were recruited [mean age = 64.1 years, standard deviation (SD) = 12.7]. Over 80% of the participants had a first-ever stroke [mean years after first stroke: 4.2 (SD = 5.1)]. The GEE analysis revealed that the intervention group participants showed significantly greater improvements in self-efficacy, satisfaction with their performance of self-management behaviors, HRQoL, and community reintegration at 8-week follow-up with respect to their baseline levels.
The COMBO-KEY program showed effective improvements in recovery outcomes of people with stroke. Future research should explore the inclusion of virtual/hybrid sessions, strategies to assess health conditions of people with stroke via online modes, and assessment of goal attainment and actual performance of self-management behaviors.
多项系统评价报告称，自我管理干预措施与脑卒中患者的自我效能感和健康相关生活质量（HRQoL）的积极影响有关。
本文报道了强化脑卒中自我管理方案的效果。
从社区组织和一个支持小组招募符合条件的脑卒中成年人，进行一项双臂、评估者盲法随机对照试验。对照组患者接受常规护理，而干预组患者还接受为期 8 周的自我管理方案，即“卒中康复之旅持续动力提升教练”（COMBO-KEY），由医疗保健专业人员和经过培训的志愿者进行 4 次上门家访和 5 次随访电话。在基线和干预后进行评估，以评估自我效能感、自我管理行为表现满意度、HRQoL 和社区融入度等结果，使用广义估计方程（GEE）进行分析。
共招募了 134 名参与者[平均年龄=64.1 岁，标准差（SD）=12.7]。超过 80%的参与者为首次脑卒中[首次脑卒中后平均年限：4.2（SD=5.1）]。GEE 分析显示，干预组患者在 8 周随访时的自我效能感、自我管理行为表现满意度、HRQoL 和社区融入度方面均显著高于基线水平。
COMBO-KEY 方案显示对脑卒中患者的康复结果有显著的改善作用。未来的研究应探索纳入虚拟/混合课程、通过在线模式评估脑卒中患者健康状况的策略，以及评估目标实现和实际自我管理行为表现。
