Self-management support for elderly people post-stroke 3- RCT-study of self-management intervention

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Background and Purpose
Elderly people denote the majority of stroke cases worldwide. Post-stroke sequelae often lead
to a more isolated and inactive life and a risk of close relatives being overburdened. The aim of this study was to investigate the effect of a novel self-management intervention targeting elderly people with stroke, on self-efficacy, quality of life and the burden on close relative.
Methods
A randomized controlled trial including participants recruited two weeks before discharge from three subacute rehabilitation units was conducted. All participants received usual care. The participants randomized to the intervention group were offered eight self-management sessions of 45–60 min duration by a physiotherapist or an occupational therapist during a period of nine months after discharge as an add-on to usual care. All participants were assessed at baseline, 3 months and 9 months after discharge on the primary outcome measure. The primary outcome was the Stroke Self-Efficacy Questionnaire. Secondary outcomes included a short version of Stroke Specific Quality of Life Scale, the Impact on Participation and Autonomy scale and the Caregiver Burden Scale (only at 3 and 9 months). Data were analysed using mixed models and paired with-in and between analysis when relevant.
Results
Sixty-nine individuals aged > 65 years with stroke were randomized. Sixty-six of these had primary outcome registered at baseline. Age participants (years), mean(sd): 76(6); Gender, m/f(%): 50/50; Age relatives (years), mean(sd): 68(11). There was no significant difference between the two groups at baseline. Six patients had loss to follow up at some point during the 9 months' project period but measurements were included when possible. The analysis showed an overall improvement in self-efficacy independent of randomization group. However, the improvement in the intervention group did not significantly differ as compared with the control group, neither in self-efficacy, quality of life nor in impact on participation and autonomy. Moreover, there was no significant difference in change between groups in regard of the caregiver burden scale. However, a significant different level at 3 and 9 months was found between the intervention group and the control group.
Conclusions
The novel self-management intervention did not improve the self-efficacy, quality of life, nor in impact on participation and autonomy compared to usual care for elderly people after stroke. The difference in caregivers' burden scale between the two groups at 3 and 9 months may suggest that the intervention had affected the caregivers already before 3 months. Further exploration is recommended.
Original languageEnglish
Publication yearMar 2022
Publication statusPublished - Mar 2022
EventDanske Fysioterapeuters fagkongres 2022 -
Duration: 17 Mar 202219 Mar 2022
https://www.fysio.dk/fafo/fagkongres-2022

Conference

ConferenceDanske Fysioterapeuters fagkongres 2022
Period17/03/202219/03/2022
Internet address

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