Multi-Center Clinical Trial: Putting stroke patients in charge improves quality of life

Medicalxpress: Community rehabilitation interventions for stroke patients have not had a great track record of delivering measurable improvements. But new research from New Zealand focused on Maori and Pacific populations shows how a cheap and simple intervention that puts the patient and families in charge can make a difference to their quality of life. The study can be found in the journal Clinical Rehabilitation.

Two interventions were trialled in this multi-center, randomized study: an inspirational DVD, and a guided ‘Take Charge’ session. Patients given theseinterventions shortly after discharge from hospital were followed up a year later, to evaluate their health-related quality of life. The Take Charge session improved patients’ physical health scores on a scale of 0-100 by six points, while the DVD upped the result by one point. Those who had received a Take Charge session were also less likely to be rated with more than ‘slight disability,’ and their carers reported a lower degree of strain.

According to theory, when someone takes charge of their own recovery from anillness or in managing a disability, their perceived quality of life improves. Yet few community rehabilitation interventions have proven effective for those who have suffered a stroke. Most are therapy-led, or involve support workers. However, a third approach in community intervention involves handing back responsibility to the patient, and promoting their self-confidence. This is the approach used in the New Zealand intervention, known as self-directed rehabilitation.

According to the authors of this report, stroke patients of Maori and Pacific ethnicity have some of the worst outcomes, despite similar levels of activity and independence to New Zealanders of European heritage on leaving hospital. So these two groups were targeted in this study. However, the authors say that emphasis on self-directed rehabilitation has the potential to improve outcomes forstroke patients from any culture. Read Full Article