一项技术支持的自我管理干预措施（iSMART）改善中风后功能的满意度、用户体验和初始疗效：一项远程随机对照试验。
Satisfaction, user experiences, and initial efficacy of a technology-supported self-management intervention (iSMART) to improve post-stroke functioning: a remoted randomized controlled trial.
作者信息
Lei Yating, Li Zhaoying, Bui Quoc, DePaul Olivia, Nicol Ginger E, Mohr David C, Fong Mandy W M, Metts Christopher L, Lee Sunghoon I, Tomazin Stephanie E, Wong Alex W K
机构信息
Department of Occupational Therapy, New York University, New York, NY, USA.
Division of Occupational Science and Occupational Therapy, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
出版信息
Top Stroke Rehabil. 2025 Jan 10:1-15. doi: 10.1080/10749357.2025.2450950.
BACKGROUND
Self-management interventions empower individuals to manage their chronic conditions and daily life after stroke. However, traditional in-person self-management interventions often face transportation and geographical barriers. Digital interventions may offer a solution to address this gap.
OBJECTIVES
This pilot randomized controlled trial (RCT) aimed to examine treatment satisfaction, user experiences, and the initial effect of the interactive Self-Management Augmented by Rehabilitation Technologies (iSMART) intervention in stroke survivors to improve post-stroke functioning.
METHODS
Participants ( = 24) with mild-to-moderate chronic stroke completed a parallel, 2-arm, nonblinded, remote RCT. They were randomly assigned to either a 12-week iSMART or a control intervention (post-stroke information). iSMART was a technology-based self-management intervention involving skill-building education, human coaching, and text messaging. Participants completed a battery measuring treatment satisfaction, use experiences, and function and participation outcomes at baseline and post-intervention.
RESULTS
iSMART participants expressed greater satisfaction with their treatment ( = 0.387), healthcare environment ( = 0.454), relationships with providers ( = 0.374), and higher expectations for positive treatment outcomes ( = 0.328) than control participants, with medium effect sizes. The iSMART group rated the overall program and its coaching, skill-building, and text messaging components as helpful. iSMART participants showed a medium effect in improving overall post-stroke functioning, but control participants showed a small effect. Moreover, iSMART participants showed moderate-to-large effects in improving hand function ( = 0.699), mobility ( = 0.499), memory and thinking ( = 0.436), communication ( = 0.416), social participation ( = 0.307), community reintegration ( = 0.652), and perceived recovery ( = 0.545).
CONCLUSIONS
Our results provide initial evidence that iSMART supports stroke survivors in managing chronic conditions and enhancing post-stroke functioning.
背景
自我管理干预措施使个体有能力管理中风后的慢性病和日常生活。然而，传统的面对面自我管理干预措施常常面临交通和地理障碍。数字干预可能提供一种解决这一差距的方法。
目的
这项试点随机对照试验（RCT）旨在研究治疗满意度、用户体验以及交互式康复技术增强自我管理（iSMART）干预对中风幸存者改善中风后功能的初步效果。
方法
24名轻度至中度慢性中风患者完成了一项平行、双臂、非盲、远程随机对照试验。他们被随机分配到为期12周的iSMART干预组或对照干预组（中风后信息）。iSMART是一种基于技术的自我管理干预措施，包括技能培养教育、人工指导和短信服务。参与者在基线和干预后完成了一系列测量治疗满意度、使用体验以及功能和参与结果的测试。
结果
与对照组参与者相比，iSMART干预组参与者对治疗（效应量=0.387）、医疗环境（效应量=0.454）、与医护人员的关系（效应量=0.374）表现出更高的满意度，对积极治疗结果的期望也更高（效应量=0.328），效应量为中等。iSMART组对整个项目及其指导、技能培养和短信服务部分给予了积极评价。iSMART干预组在改善中风后整体功能方面显示出中等效应，但对照组显示出较小效应。此外，iSMART干预组在改善手部功能（效应量=0.699）、活动能力（效应量=0.499）、记忆和思维（效应量=0.436）、沟通（效应量=0.416）、社会参与（效应量=0.307）、社区重新融入（效应量=0.652）和自我感觉恢复（效应量=0.545）方面显示出中度至较大效应。
结论
我们的结果提供了初步证据，表明iSMART有助于中风幸存者管理慢性病并增强中风后功能。
Zotero 插件