Effects of a web-based stroke education program on recurrence prevention behaviors among stroke patients: a pilot study

Abstract

The effectiveness of methods to prevent stroke recurrence and of education focusing on learners' needs has not been fully explored. The aims of this study were to assess the effects of such interventions among stroke patients and their primary caregivers and to evaluate the feasibility of a web-based stroke education program. The participants were 36 patients with a clinical diagnosis of ischemic stroke within 12 months post-stroke and their primary caregivers. The participants were randomly assigned to either an experimental or a control group. The primary measures included blood chemistry, self-reported health behaviors, sense of control, and health motivation for stroke patients, and caregiver mastery for caregivers. To test the feasibility of the intervention program, the rates of participation and occurrence of technical problems were calculated. The experimental group tended to improve significantly more than the control group in terms of exercise, diet, sense of control and health motivation for the stroke patients and in terms of caregiver mastery for the primary caregivers. The rate of participation in the web-based program was 63.1%. This program, which focuses on recurrence prevention in stroke patients and caregivers, has the potential to improve health behaviors for stroke patients.

Update on the State of the Evidence for Stroke Family Caregiver and Dyad Interventions

“…9,10,13,14,17,18 One large study used cluster randomization by unit. 11 The remaining three studies were quasi-experimental (e.g., non-random assignment to condition 12,16 or single group 15 ).…”

“…11 Five studies had sample sizes of less than 50. 10,12,14,15,17 These studies should be interpreted with caution, particularly since small pilot studies do not provide meaningful effect size estimates for larger studies, let alone enough power for hypothesis testing. 19 Some smaller studies reported statistically significant results, which could have resulted from Type I error.…”

“…13 Two studies included caregivers of survivors who were 60 years of age or older, 13,15 resulting in limited generalizability for survivors who are in early to mid-life and experiencing the unique stressors that accompany those life stages. 21 Six countries were represented (USA, 9,14,18 Canada, 10 UK, 11 Germany, 12,13 Netherlands, 16 Korea 15,17 ), many with drastically different healthcare systems and cultural norms around illness recovery and caregiving, raising further questions about generalizability; however, these studies provide a more global perspective.…”

“…10,15–17 Recommendations from the original scientific statement emphasized the importance of using a combination of skill-building and psycho-educational interventions. 4 Skill-building strategies focus on processes such as problem solving, stress management, goal setting, or hands on training.…”

“…One study was delivered via the web. 17 The current lack of web-based interventions is noteworthy, considering the increase in technology use among a wide variety of family caregivers. 22 …”