Page 157 - Hospital Authority Convention 2018

Special Sessions

SS4.2 Translational Nursing and Its Applications 09:00 Theatre 2

An Empowerment Programme on Self-management and Functional Recovery among Stroke Survivors: Empirical
Effects and Translational Challenges
Sit J
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong HOSPITAL AUTHORITY CONVENTION 2018

Background
Self-management (SM) after a stroke is a challenge as multi-faceted care needs and complex disabling consequences
bring further hindrance to patient participation. A 13-week stroke patient empowerment intervention was implemented
in an ambulatory rehabilitation setting to enhance their ability to participate in self-management for a better transition to
community living.

Purpose
To investigate the effects of patient empowerment intervention on stroke survivors’ self-efficacy in illness management,
self-management behaviours and functional outcomes, and to explore their experiences and strategies used (if any) in
participating stroke self-management.

Methodology
Two-phase sequential explanatory mixed methods design. Phase I (quantitative) assessed intervention effects on stroke
participants’ self-efficacy in illness management, SM behaviour and functional recovery, with participants randomly assigned
to intervention (IG) or control (CG, usual rehabilitation programme) groups. Generalised estimating equations assessed
between-group changes in outcome parameters over time at baseline (T0), three-month post-intervention (T1) and six-month
post-intervention (T2). During phase two, semi-structured interviews (qualitative) explored stroke SM strategies and hindrance
from participants’ perspective.

Results
In Phase 1, a total of 210 (IG=105, CG=105) stroke participants (mean age = 69 years, 49% women, 72% ischaemic stroke,
89% hemiparesis and 63% tactile sensory deficit) enrolled in the study. Those in IG reported better self-efficacy in illness
management three-month (p=0.011) and six-month (p=0.012) post-intervention; along with better self-management
behaviours at all follow-up time points (all p<0.05). Those in IG had significantly better functional recovery (Barthel, all p<0.05;
Lawton, all p<0.05), compared to CG. In Phase 2, content analysis revealed three categories of self-management strategies
adopted, namely role perception, self-management strategies, and over-whelming and unpredictable experiences.
Conclusions
Stroke survivors could benefit from patient empowerment intervention which influences self-efficacy in illness management;
improve self-management behaviour and functional recovery. Interview findings provide contextual information for a
comprehensive understanding of stroke participants’ experiences and strategies used in participating in stroke SM.
Furthermore, patient empowerment intervention can be conducted in parallel with existing ambulatory stroke rehabilitation
services and provide added value in fostering self-management of post-stroke and improve functional recovery in longer
term. Tuesday, 8 May 2018

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