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Wu SY, Li YC, Chen YW, Chen CL, Pan HC, Lin KC, Lau HY. Construct validity, responsiveness, minimal detectable change, and minimal clinically important difference of the stroke self-efficacy questionnaire in individuals receiving stroke rehabilitation. Disabil Rehabil 2024:1-9. [PMID: 38433459 DOI: 10.1080/09638288.2024.2324122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To assess the clinimetric properties of the Stroke Self-Efficacy Questionnaire (SSEQ) and estimate the minimal detectable change (MDC) and minimal clinically important difference (MCID) from the database of our randomized controlled trials (RCT) of individuals receiving stroke rehabilitation. METHODS We retrieved the pre- and post-intervention scores of the SSEQ and Stroke Impact Scale (SIS) from 80 stroke survivors. The analysis of clinimetric properties was performed using: (1) confirmatory factor analysis and item response theory modeling (IRT) for construct validity; (2) standardized response mean and Glass's delta for responsiveness; (3) MDC based on the standard deviation (SD) or standard error of measurement (SEM) of the SSEQ change scores; (4) MCID determined by the external anchor-SIS; (5) conditional MDC (cMDC) derived from the IRT analysis. RESULTS There was a bi-factorial construct with excellent model-data fit and marked responsiveness. The MDC determined by the SD and SEM were 1.5 and 3.0, respectively, and the MCIDs were 3.3 and 3.7. CONCLUSIONS This study confirmed that SSEQ is a valid and reliable assessment tool for patients receiving stroke rehabilitation. We also provided practical threshold values, especially demonstrating the benefit of using individualized cMDC, to help clinicians better interpret the change in the SSEQ scores.
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Affiliation(s)
- Sz-Yan Wu
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
- Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Chun Li
- Department of Occupational Therapy, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Wen Chen
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Early Intervention, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Chieh Pan
- Department of Physical Medicine and Rehabilitation, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Hiu-Ying Lau
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan
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Flink M, Lindblom S, von Koch L, Carlsson AC, Ytterberg C. Health literacy is associated with less depression symptoms, higher perceived recovery, higher perceived participation, and walking ability one year after stroke - a cross-sectional study. Top Stroke Rehabil 2023; 30:865-871. [PMID: 36803670 DOI: 10.1080/10749357.2023.2178133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Life after stroke may entail several lifestyle changes and new routines. Hence, it is imperative for people with stroke to understand and make use of health information, i.e. to have sufficient health literacy. This study aimed to explore health literacy and its associations with outcomes at 12-months post-discharge regarding depression symptoms, walking ability, perceived stroke recovery, and perceived participation in people with stroke. METHODS This was a cross-sectional study of a Swedish cohort. Data were collected at 12 months post-discharge using European Health Literacy Survey Questionnaire, the Hospital Anxiety and Depression Scale, the 10-m walk test, and the Stroke Impact Scale 3.0. Each outcome was then dichotomized into favorable versus unfavorable outcome. Logistic regression was performed to assess the association between health literacy and favorable outcomes. RESULTS The participants, n = 108, were on average 72 years old, 60% had mild disability, 48% had a university/college degree, and 64% were men. At 12 months post-discharge, 9% of the participants had inadequate health literacy, 29% problematic health literacy, and 62% sufficient health literacy. Higher levels of health literacy were significantly associated with favorable outcomes relating to depression symptoms, walking ability, perceived stroke recovery, and perceived participation in models adjusted for age, sex, and education level. CONCLUSION The association between health literacy and mental, physical, and social functioning 12-months post-discharge suggests that health literacy is an important factor to consider in post-stroke rehabilitation. Longitudinal studies of health literacy in people with stroke are warranted to explore the underlying reasons for these associations.
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Affiliation(s)
- Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Research and Development Unit for Elderly Persons (FOU nu), Region Stockholm, Stockholm, Sweden
| | - Sebastian Lindblom
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme of Heart & Vascular and Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Axel C Carlsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
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Fleming TK, Schwartz JK, Belagaje SR, Katz LW, Strow JT. Medication Management After Stroke. Arch Phys Med Rehabil 2023; 104:1739-1744. [PMID: 37100269 DOI: 10.1016/j.apmr.2023.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/28/2023]
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Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Patel T, Ho CH, Packer TL, Lofters AK, Hahn-Goldberg S, McCarthy LM, Guilcher SJT. Medication self-management interventions for persons with stroke: A scoping review. PLoS One 2023; 18:e0285483. [PMID: 37200316 DOI: 10.1371/journal.pone.0285483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tejal Patel
- University of Waterloo School of Pharmacy, Kitchener, ON, Canada
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada
- Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Chen J, Tian Y, Yin M, Lin W, Tuersun Y, Li L, Yang J, Wu F, Kan Y, Li X, Gan Y, Sun X, Wu Y, He F. Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study. J Psychosom Res 2023; 164:111105. [PMID: 36495756 DOI: 10.1016/j.jpsychores.2022.111105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed to explore the effects of self-efficacy on adherence to self-management and medication among patients with chronic diseases in China. METHODS A cross-sectional survey of 2047 patients with chronic diseases in 120 cities across China was conducted between May and September 2021 using a multi-stage sampling method. Self-efficacy was measured using the New General Self-Efficacy Scale. The adherence to self-management was measured using the item response theory based self-management adherence scale, and the medication adherence was assessed using the Medication Adherence Scale for the Chronically Ill. The adherence to self-management and medication were evaluated by linear regression and logistic regression models, respectively. RESULTS After adjusting for all covariates, self-efficacy was significantly associated with adherence to self-management (β =0.207, 95% CI =0.064-0.350, P = 0.005), but not with medication adherence (for[middle/low]: OR = 1.119, 95% CI =0.828-1.511, P = 0.47; for[high/low]: OR = 1.281, 95% CI =0.935-1.754, P = 0.12). In subgroup analysis, self-efficacy positively correlated with adherence to self-management in patients with multiple chronic diseases (β =0.286, 95% CI =0.037-0.535, P = 0.03), but not in those with only one chronic disease (P = 0.12). Self-efficacy was not significantly associated with medication adherence in any of the subgroups. CONCLUSION Self-efficacy was positively associated with adherence to self-management in patients with chronic diseases, but not with medication adherence. Enhanced health education in patients with one chronic disease alone may have an association with better adherence to self-management and medication in daily life.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China; Institute of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yaoming Tian
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Minggang Yin
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Wei Lin
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yusupujiang Tuersun
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Jiao Yang
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Xialei Li
- School of Pharmaceutical Sciences, Shandong University, No.44 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan City, Hubei Province, China
| | - Xinying Sun
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China.
| | - Feiying He
- Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China.
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Junaid Farrukh M, Makmor Bakry M, Hatah E, Hui Jan T. Medication adherence status among patients with neurological conditions and its association with quality of life. Saudi Pharm J 2021; 29:427-433. [PMID: 34135668 PMCID: PMC8180465 DOI: 10.1016/j.jsps.2021.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/03/2021] [Indexed: 11/26/2022] Open
Abstract
Background/Aim Medication non-adherence may cause significant morbidity and mortality in patients with chronic diseases and may increase the economic burden on the healthcare system. The prevalence of neurological disorders is increasing in Malaysia; however, comprehensive data on medication adherence among Malaysian patients with these disorders is limited. This study was conducted to determine the association of medication non-adherence with quality of life in patients with neurological problems. Methods A cross-sectional survey was performed in 370 patients diagnosed with epilepsy, Parkinson's disease, stroke and Alzheimer's disease at Neurology clinic. Patients aged 18 years or older, without documented physical or psychiatric illness such as schizophrenia and major depression, were included. Patient-administered questionnaires, such as the Malaysian Medication Adherence Scale and Medication Possession Ratio were used to determine medication adherence. An established EQ-5D-3L questionnaire was used to determine quality of life. Data were analysed using descriptive and inferential analysis. Results The overall prevalence of medication non-adherence among patients with neurological disorders was 59.2%. Among these neuromedical diseases, 69.2% (n = 9/13) of Alzheimer's disease, 66.7% (n = 98/147) of epilepsy, 62.1% (n = 36/58) of Parkinson's disease and 48.7% (n = 74/152) of stroke patients were found non-adherent. There was a significant difference in EQ-5D index scores (p = 0.041) between adherent and non-adherent patients. Conclusion A high prevalence of medication non-adherence was found among patients with neurological disorders. The rate of non-adherence varied among different neurological conditions. There was a significant difference in quality of life between adherent and non-adherent patients.
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Affiliation(s)
- Muhammad Junaid Farrukh
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Mohd Makmor Bakry
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ernieda Hatah
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Tan Hui Jan
- Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Malaysia
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Widjaja KK, Chulavatnatol S, Suansanae T, Wibowo YI, Sani AF, Islamiyah WR, Nathisuwan S. Knowledge of stroke and medication adherence among patients with recurrent stroke or transient ischemic attack in Indonesia: a multi-center, cross-sectional study. Int J Clin Pharm 2020; 43:666-672. [PMID: 33124676 DOI: 10.1007/s11096-020-01178-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
BackgroundThere is a limited data in Indonesia regarding the stroke knowledge and medication adherence among stroke survivors.ObjectiveTo assess the level of stroke knowledge and medication adherence along with their relationship among stroke survivors.SettingTwo tertiary-care hospitals in Surabaya, East Java, Indonesia.MethodsA prospective, cross-sectional study was conducted among 215 stroke survivors. Stroke Knowledge Test and the Morisky Green Levine Adherence Scale questionnaires were used to evaluate stroke knowledge and medication adherence, respectively. Binary logistic regression was performed to assess the rela tionship between stroke knowledge and medication adherence. Main outcome measuresRelationship between stroke knowledge and medication adherence.ResultsA total of 215 patients with mean age of 56.34 ± 8.69 years were recruited into this study. Mean Stroke Knowledge Test score was 7.89 ± 3.38 with 76.7% had low level of stroke knowledge. Mean Morisky Green Levine Adherence Scale was 3.05 ± 1.11 with 52.1% had low to medium medication adherence. Education and duration of stroke correlated with stroke knowledge level (Spearman's correlation coefficient: 0.307, p = 0.001 and 0.128, p = 0.041, respectively). Age and disability correlated with medication adherence (Spearman's correlation coefficient: 0.169; p = 0.013 and 0.171; p = 0.012), respectively. After adjustment for covariates, stroke knowledge level was independently associated with medication adherence (adjusted OR: 4.37, 95% CI 2.00-9.53; p < 0.001).ConclusionStroke knowledge was low among Indonesian stroke survivors and independently related to medication adherence. Attempts should be made to increase stroke knowledge which may improve medication adherence among stroke survivors.
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Affiliation(s)
- Karina Kumaladewi Widjaja
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayutthaya Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Suvatna Chulavatnatol
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayutthaya Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Thanarat Suansanae
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayutthaya Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Yosi Irawati Wibowo
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - Achmad Firdaus Sani
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Surakit Nathisuwan
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayutthaya Road, Ratchathewi, Bangkok, 10400, Thailand.
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Appalasamy JR, Quek KF, Md Zain AZ, Joseph JP, Seeta Ramaiah S, Tha KK. An Evaluation of the Video Narrative Technique on the Self-Efficacy of Medication Understanding and Use Among Post-Stroke Patients: A Randomized-Controlled Trial. Patient Prefer Adherence 2020; 14:1979-1990. [PMID: 33116441 PMCID: PMC7585263 DOI: 10.2147/ppa.s253918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Self-efficacy is positively associated with medication understanding and use self-efficacy (MUSE) among post-stroke patients. It is also closely related to knowledge, belief, and perception, which vary among people from different socioeconomic backgrounds and cultures. As interventions using video and peer stories have emerged to be successful on behavior modification, this study aimed to explore the effectiveness of video narratives incorporated with Health Belief constructs on MUSE and its associated factors among patients with stroke at a local setting. METHODS A randomized controlled trial (RCT) for 12 months was carried out on patients diagnosed with stroke at Hospital Kuala Lumpur, Malaysia. The RCT recruited up to 216 eligible patients who were requested to return for two more follow-ups within six months. Consented patients were randomized to either standard care or intervention with video narratives. The control of potential confounding factors was ensured, as well as unbiased treatment review with prescribed medications, only obtained onsite. RESULTS AND DISCUSSION A repeated measure of MUSE mean score differences at T0 (baseline), T2 (6th month) and T4 (12th month) for antithrombotic, antihypertensive, and all medication categories indicated significant within and between groups differences in the intervention group (p<0.05). Moreover, this impact was reflected upon continuous blood pressure (BP) monitoring compared to the control group (F (1214) =5.23, p=0.023, ƞ2=0.024). Though BP measure differences were non-significant between the groups (p=0.552), repeated measure analysis displayed significant mean differences between intervention and control group on BP control over time (F (1.344, 287.55) =8.54, P<0.001, ƞ2=0.038). Similarly, the intervention's positive impact was also present with similar trends for knowledge, illness perception, and the belief about medicine. Though significant differences (p<0.05) of all outcome measures gradually decreased between T2 and T4 in the intervention group; nevertheless, these positive findings confirmed that personalized video narratives were able to motivate and influence MUSE and its associated factors among post-stroke patients. The significant improvement in medication-taking self-efficacy and the sustenance of BP monitoring habits among patients in the intervention group strengthened our conceptual framework's practicality.
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Affiliation(s)
- Jamuna Rani Appalasamy
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Anuar Zaini Md Zain
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Joyce Pauline Joseph
- Department of Neurology, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Kyi Kyi Tha
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
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