Abstract 158: An Evaluation Of Stroke Survivors' Self-efficacy In Self-management Using A Stroke Telehealth Service

Abstract

Background: Previous studies indicate that stroke survivors encounter difficulties in participating in self-management programs because of lack of transportation to rehabilitation centres and unsuitable scheduling. A virtual multidisciplinary stroke care clinic (VMSCC) that builds on the advantages of self-management programs to promote survivors’ recovery and improve caregivers’ outcomes was developed. Methods: A VMSCC was set up to facilitate the interactions between the participants and the healthcare professionals. Participants received a device kit containing a tablet and a clinically validated wireless home blood pressure monitoring device. It was encouraged that survivors monitor their blood pressure daily to take an active role in managing their health. Registered nurses conducted Skype-based video calls with stroke survivors on issues relating to stroke self-management. A nurse reviewed blood pressure data before video calls and used online tools to reinforce self-management knowledge and skills during the video calls. A hotline for psychological and non-urgent health concerns was also maintained by the nurse in the call centre. To determine its effectiveness on stroke survivors' self-efficacy in self-management, a two-arm randomised controlled trial was conducted. We measured self-efficacy outcome using the Stroke Self-Efficacy Questionnaire at baseline (shortly before discharge) and 3 and 6 months after study initiation. Results: We recruited 274 participants from 10 Hong Kong's public hospitals. At 3 months (T1) and 6 months (T2), survivors in the control group demonstrated no significant difference in the change of self-efficacy with respect to T0 (baseline). The generalized estimating equations analysis showed a significant change and estimated additional improvement in self-efficacy in the intervention group at T2. Discussion: VMSCC's intervention was based on self-efficacy theory, which identified perceptions of personal capability as a significant variable associated with stroke outcomes. The development of a self-management program based on the self-efficacy theory was further supported by significant improvements in self-efficacy in the intervention group in this study.