Effectiveness of the Restore4Stroke self-management intervention ”Plan Ahead!”: A randomized controlled trial in stroke patients and partners
Nienke S. Tielemans , Johanna M. A. Visser-Meily, Vera P.M. Schepers, Patricia E. Passier, Ingrid G.L. van de Port, Judith D.M. Vloothuis, Pieter A.A. Struyf, Caroline M. van Heugten
School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
Objective: To investigate the effectiveness of a self-management intervention aimed at proactive coping for stroke patients and partners, compared with an education intervention.
Design: Multicentre randomized controlled trial.
Participants: The study included 113 stroke patients (mean age 57.0 years (standard deviation (SD) 9.0), mean 18.8 months after stroke (SD 28.4)) and 57 partners (mean age 59.2 years (SD 8.3)).
Methods: Participants were randomized to a self-management intervention, or an education intervention, both 10 weeks’ duration, outpatient, stroke-specific, and group-based. Main patient inclusion criteria were symptomatic stroke (≥ 6 weeks previously) and reporting ≥ 2 restrictions on the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation Participation. Measurements were performed immediately after intervention, and at 3 and 9 months follow-up. Primary patient and partner outcomes were proactive coping and participation restrictions. Analyses were based on linear mixed modelling.
Results: A significant effect was found only in partners’ increased proactive coping at T2 (compared with education intervention). Beneficial trends were found for the self-manage-ment intervention in partners’ self-efficacy and
patients’ health-related quality of life, mood complaints and participation restriction.
Conclusion: Little convincing evidence was found favouring our self-management intervention over the education intervention; therefore, the self-management intervention should not be implemented yet in clinical practice. Further research is needed to explore beneficial trends.
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