Abstract 45: A Stroke Self-Management Program to Enhance Self-Efficacy and Outcome Expectation: A Randomized Controlled Trial

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Introduction: Evidence has shown maintaining stroke survivors’ confidence and supporting their self-management after discharge were associated with improved stroke recovery. Aim: To test in a randomized controlled trial whether a self-efficacy and outcome expectation enhancing stroke self-management program improved health outcomes. Methods: Eligible adult survivors recruited from three acute stroke units were randomized to a new 4-week stroke self-management program (SESSMP) or usual care. The program, underpinned by Bandura’s constructs of self-efficacy and outcome expectation, offered home visits, community group sessions and follow-up phone calls. Primary outcomes included self-efficacy and outcome expectation of self-management. Secondary outcomes included satisfaction with performance of self-management behaviors, health-related quality of life (HRQoL), depressive symptoms and community reintegration. Differential changes of outcomes from baseline to 8-weeks follow-up (one-month post-program) between the two groups were evaluated by generalized estimating equations. Results: We recruited 128 participants (mean age 67.46 years, SD 11.95). The SESSMP group in the intention-to-treat (ITT) population showed significantly greater improvements in primary and secondary outcomes except depressive symptoms than the control group across time. Analyses of ITT and per-protocol populations found the changes in scores of all primary and secondary outcomes across time between the two groups comparable. Those receiving all sessions had the greatest and significant increase in self-efficacy, outcome expectation and HRQoL across time compared to those completing only part of the SESSMP and to the control group. No program-related adverse effects were reported. Majority receiving the SESSMP found home visits by nurses and videos about stroke volunteers’ recovery experiences most helpful. Conclusions: The results suggested the SESSMP improved survivors’ confidence, positive expectations, self-management behaviors, HRQoL and social outcomes.