Age and Ageing Advance Access published online on March 14, 2007
Age and Ageing, doi:10.1093/ageing/afm003
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Randomised trial of a computer-generated tailored written education package for patients following stroke
1 Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia 4072
2 Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia 4072
3 Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia 4029
Address correspondence to: Tammy Hoffmann. Tel: +61 7 3365 2306; Fax: +61 7 3365 1622. Email: t.hoffmann{at}uq.edu.au
Background: the ideal method of providing stroke patients with information has not been established.
Objectives: to evaluate the effectiveness of providing stroke patients with computer-generated tailored written information.
Design: randomised controlled trial with blinded assessor.
Setting: acute stroke unit.
Participants: 138 stroke patients.
Methods: patients were randomised to receive either computer-generated tailored written information about stroke or generic written information while i hospital.Three months following discharge, a blinded assessor evaluated the outcomes of knowledge about stroke, self-efficacy (Self-Efficacy to Perform Self-Management Behaviours Scale), anxiety and depression (Hospital Anxiety and Depression (HAD) Scale), perceived health status (COOP charts), satisfaction with content and presentation of the written information received (separate 10-point visual analogue scale for content and presentation), and desire for additional information.
Results: complete data were obtained for 133 (96.4%) patients. Patients in the intervention group were significantly more satisfied with the content (difference on a 10-point visual analogue scale was 1, 95% confidence interval 0.4 to 1.7, P = 0.003) and presentation (difference on a 10-point visual analogue scale was 1.2, 95% confidence interval 0.6 to 1.9, P < 0.001). Significantly, fewer patients in the intervention group desired additional information about stroke at follow-up than patients in the control group (4.5% versus 32.8%; P < 0.001). Anxiety change scores improved slightly more in favour of the control group (1.4 difference on the HAD subscale, 95% confidence interval 0.2 to 2.8, P = 0.03). No significant differences between the groups were observed for any of the other outcome measures.
Interpretation: providing stroke patients with computer-generated tailored written information improved satisfaction with the information that was received and was more effective in meeting patients' informational needs than non-tailored information, but had no effect on knowledge about stroke, self-efficacy, depression, or perceived health status.
Keywords: stroke, patient education, elderly
Received 11 September 2006; accepted in revised form 18 December 2006.
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