Abstract WMP39: Effects Of A Home Visiting And Phone Coaching Self-management Program For Stroke Survivors: A Randomized Controlled Trial

Abstract

Introduction: Systematic reviews show that self-management interventions were associated with significant improvements in stroke survivors’ activities of daily living and quality of life. However, the programmes were largely group-based and held in community settings. It may limit access by stroke survivors who have greater physical impairment or are more vulnerable to adverse events. Aim: This study aimed to develop and evaluate the effects of a new, 8-week, individual-based self-management program on stroke survivors’ self-efficacy in performing self-management behaviors and level of community reintegration. Methods: A 2-arm randomized controlled trial was conducted. A convenience sample of adults who had a first-ever/recurrent ischemic/hemorrhagic stroke were recruited from community-based rehabilitation organisations and support groups. The participants in the intervention group received the self-management program and usual care. The program included four home visits and five phone coaching sessions held weekly over eight weeks. It was led by a healthcare professional who conducted home visits and supported by a trained volunteer who provided phone coaching. Access to the program website and a workbook with essential information about self-management and peer survivors’ sharing of survival experiences in videos was also provided. The generalised estimating equations (GEE) model was used to compare the difference in outcomes between the intervention and control groups at post-intervention compared to baseline. Results: A total of 134 participants (mean age=64.06 years; SD=12.69) were recruited. The mean years after a stroke was 4.19 years (SD=5.07). The adjusted GEE analysis results showed that participants in the intervention group improved significantly more in total scores of the Stroke Self-Efficacy Questionnaire and the Reintegration into Normal Living Index at follow-up with respect to baseline compared to those in the control group. Conclusions: The results supported the benefits of the self-management program. The model of collaboration between healthcare professionals and trained volunteers in the program delivery could be further explored to optimize the continuity of self-management support to stroke survivors.