Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients

Al Rasyid; Uke Pemila; Siti Aisah; Salim Harris; Elvan Wiyarta; Marc Fisher

doi:10.3389/fneur.2023.1177083

Exploring the self-efficacy and self-care-based stroke care model for risk factor modification in mild-to-moderate stroke patients

Front Neurol. 2023 May 11:14:1177083. doi: 10.3389/fneur.2023.1177083. eCollection 2023.

Authors

Al Rasyid¹, Uke Pemila², Siti Aisah³, Salim Harris¹, Elvan Wiyarta⁴, Marc Fisher⁵

Affiliations

¹ Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
² Directorate of Health Service Governance, Indonesian Ministry of Health, Jakarta, Indonesia.
³ Department of Medical Surgery, Faculty of Nursing, Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
⁴ Department of Medical Science, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
⁵ Beth Israel Deaconess Medical Center, Boston, MA, United States.

Abstract

Context: The worldwide burden of stroke is projected to grow unless proper stroke education is implemented. Information alone cannot promote patient self-efficacy and self-care and reduce risk factors.

Aim: This trial aimed to test self-efficacy and self-care-based stroke education (SSE) on changes in self-efficacy, self-care, and risk factor modification.

Design setting and participants: This study is a single-center, double-blinded, interventional, two-arm randomized controlled trial with a 1- and 3-month follow-up in Indonesia. Between January 2022 and October 2022, 120 patients were prospectively enrolled from Cipto Mangunkusumo National Hospital, Indonesia. Participants were assigned using a computer-generated random number list.

Intervention: SSE was given before discharge from the hospital.

Primary outcome measure: Self-care, self-efficacy, and stroke risk score was measured 1 month and 3 months after discharge.

Secondary outcome measure: Modified Rankin Scale, Barthel Index, and blood viscosity was measured at 1 month and 3 months after discharge.

Results: A total of 120 patients (intervention n = 60; standard care n = 60) were randomized. In the 1st month, the intervention group showed a more significant change in self-care (4.56 [95% CI: 0.57, 8.56]), self-efficacy (4.95 [95% CI: 0.84, 9.06]), and stroke risk (-2.33 [95% CI:-3.19, -1.47]) compared to the controlled group. In the 3rd month, the intervention group also showed a more significant change in self-care (19.28 [95% CI: 16.01, 22.56]), self-efficacy (19.95 [95% CI: 16.61, 23.28]), and stroke risk (-3.83 [95% CI: -4.65, -3.01]) compared to the controlled group.

Conclusion: SSE may boost self-care and self-efficacy, adjust risk factors, enhance functional outcomes, and decrease blood viscosity.

Clinical trial registration: ISRCTN11495822.

Keywords: Indonesia; discharge education; ischemic stroke; patient education; prevention; self-confidence.

Grants and funding

This study was funded by the Universitas Indonesia Directorate of Research and Development and the Ministry of Research/National Agency for Research and Innovation via the Publikasi Terindeks Internasional (PUTI) Q1 grant number NKB-404/UN2.RST/HKP.05.00/2022.