Abstract NS7: The Effects of a Theory-based Health Empowerment Intervention on Self-management and Functional Recovery Post-stroke

Abstract

Introduction: Self-management post-stroke is challenging due to its sudden and complex sequela. Identification of an effective intervention to foster self-management post-stroke is needed. We developed a 13-week Stroke Patient Empowerment Intervention (SPEI), guided by Shearer’s Theory of Health Empowerment, to foster patients’ inner resources and social-contextual resources to enhance self-management. Objective: To examine the effects of the SPEI (six 20-min small group sessions and 2 phone follow-ups) on self-efficacy (SE), self-management behaviour and functional recovery, compared to usual ambulatory rehabilitation care (UC). Methods: In this randomized controlled trial, Hong Kong Chinese participants (mean age=69 years, 48% women, 72% ischemic stroke, 89% hemiparesis and 63% tactile sensory deficit) received 13-weeks of SPEI+UC (n=105) or UC only (n=105). Generalized estimating equations were used assess changes in SE (stroke-specific and illness management), self-management behaviours (cognitive symptom management, communication with physician, medication adherence, and BP self-monitoring) and functional recovery (Barthel and Lawton Indices) over time (baseline=T0, 1-week=T1, 3-months=T2 and 6-months=T3 post-intervention) between groups, using intention-to-treat. Results: Those in the SPEI+UC group had significantly better illness management SE, self-management behaviours (cognitive symptom management, communication with physician, and BP self-monitoring), and functional recovery (Barthel and Lawton Indices), compared to UC. Changes in stroke-specific SE and medication adherence were not significantly different over time between groups (see Table 1). Attrition was low (16.7%). Conclusions: This nurse-led SPEI was easily implemented and can readily be conducted in tandem with existing ambulatory stroke rehabilitation services, to foster self-management post-stroke and improve functional recovery.