Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

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A systematic meta-review of self-management support for people with dementia

Dementia ◽

10.1177/1471301218772894 ◽

2018 ◽

Vol 19 (2) ◽

pp. 253-269

Author(s):

Judith G Huis in het Veld ◽

Renate Verkaik ◽

Berno van Meijel ◽

Anneke L Francke

Keyword(s):

Systematic Reviews ◽

Well Being ◽

Self Management ◽

Cochrane Library ◽

Future Research ◽

Management Support ◽

People With Dementia ◽

Literature Searches ◽

Meta Review ◽

The Cochrane Library

Self-management support for people with dementia is important to help them and their family caregivers to cope with challenges in daily live. Insight into the effects of self-management support interventions on people with dementia is however lacking, despite existing relevant systematic reviews. We therefore conducted a meta-review of relevant systematic reviews, following the PRISMA statement. Systematic literature searches were conducted in PubMed, CINAHL, the Cochrane Library, Embase and PsycINFO. The searches were done in December 2015, and all relevant references until then were taken into consideration. No conclusions about the effects of self-management support interventions on people with dementia could be drawn. Recommendations for future research and practice include that self-management support interventions and effect measurements should be wider in scope than psychological well-being.

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Abstract NS1: Mobile Health Technology Is Feasible And Effective For Self-management Support Among Underserved Stroke Survivors

Stroke ◽

10.1161/str.53.suppl_1.ns1 ◽

2022 ◽

Vol 53 (Suppl_1) ◽

Author(s):

Jane Anderson ◽

Barbara Kimmel ◽

Shubhada Sansgiry ◽

Gina Evans-Hudnall ◽

Anette Ovalle ◽

...

Keyword(s):

Risk Factors ◽

Mobile Health ◽

Goal Attainment ◽

Community Integration ◽

Health Technology ◽

Self Management ◽

Stroke Survivors ◽

Management Support ◽

Mobile Health Technology ◽

Stroke Knowledge

Background and Purpose: Self-management Support (SMS) helps stroke survivors control risk factors to prevent second stroke. Little is known about feasibility and effectiveness of using mobile health technology (MHT) for SMS among underserved stroke survivors. The investigators studied feasibility and effectiveness of using a video teleconference mobile application to deliver a SMS program to underserved, hard to reach stroke survivors. Methods: The Video teleconference Self-management TO Prevent stroke (V-STOP) program was evaluated using longitudinal design with measurements at baseline, immediately post intervention (6 weeks), intermediate (12 weeks), and at study end (18 weeks). Medically underserved stroke survivors with uncontrolled stroke risk factors were included. Feasibility was assessed as time in intervention, telehealth satisfaction, stroke knowledge and SMS effectiveness were measured as psychological (depression, PHQ-8; anxiety, GAD-7), social (community integration questionnaire), and stroke self-management (goal attainment) outcomes. Generalized estimating equations were used with site and time in intervention as covariates. Results: V-STOP was successfully delivered to 106 participants using MHT over 2 years. Mean age was 59.3 (±10.9), majority were white (82.1%), males (54.3%), not living alone (85.9%), married (52.8%), with low annual income (<$25,000) ( 58.5%), and health insurance (59.4%). Program feasibility indicated mean number of V-STOP sessions were 4.6 (±1.8), with 4.4 (±2.0) hours of total time for the intervention. Overall satisfaction at 6 weeks with V-STOP (4.8(±0.5)) and telehealth (4.7(±0.5)) was high. Stroke knowledge was high at 12 weeks (9.6(±0.7)). SMS effectiveness indicated improvement in psychological outcomes at 6, 12, and 18 weeks from baseline; depression (18 weeks - β = 0.64 (CI 0.49-0.84)) and anxiety (18 weeks - β = 0.66 (CI 0.51-0.85)). Community integration improved by 18 weeks - β = 1.08 (CI 1.01-1.16) and stroke self-management also improved long term at 12 and 18 weeks (β = 0.92 (CI 0.84-0.99). Conclusion: MHT is feasible to deliver SMS to underserved stroke survivors. It improves psycho-social and self-management goal setting and goal attainment outcomes.

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Self-management support for stroke survivors may improve independence

10.3310/signal-000134 ◽

2015 ◽

Author(s):

Keyword(s):

Self Management ◽

Stroke Survivors ◽

Management Support

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A Study on Development and Short-term Evaluation of a Self-Management Support Program for Post Stroke Survivors and Families

Health Education and Public Health ◽

10.31488/heph.135 ◽

2020 ◽

Vol 3 (1) ◽

Keyword(s):

Support Program ◽

Self Management ◽

Stroke Survivors ◽

Management Support ◽

Short Term ◽

Post Stroke ◽

Short Term Evaluation ◽

Term Evaluation

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Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews

BMJ Open ◽

10.1136/bmjopen-2018-024262 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024262 ◽

Cited By ~ 27

Author(s):

Mireille Captieux ◽

Gemma Pearce ◽

Hannah L Parke ◽

Eleni Epiphaniou ◽

Sarah Wild ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Systematic Reviews ◽

Self Management ◽

Management Support ◽

Policy Makers ◽

Support Strategies ◽

Meta Review ◽

Secondary Outcomes

ObjectivesSelf-management support aims to give people with chronic disease confidence to actively manage their disease, in partnership with their healthcare provider. A meta-review can inform policy-makers and healthcare managers about the effectiveness of self-management support strategies for people with type 2 diabetes, and which interventions work best and for whom.DesignA meta-review of systematic reviews of randomised controlled trials (RCTs) was performed adapting Cochrane methodology.Setting and participantsEight databases were searched for systematic reviews of RCTs from January 1993 to October 2016, with a pre-publication update in April 2017. Forward citation was performed on included reviews in Institute for Scientific Information (ISI) Proceedings. We extracted data and assessed quality with the Revised-Assessment of Multiple Systematic Reviews (R-AMSTAR).Primary and secondary outcome measuresGlycaemic control as measured by glycated haemoglobin (HbA1c) was the primary outcome. Body mass Index, lipid profiles, blood pressure and quality of life scoring were secondary outcomes. Meta-analyses reporting HbA1c were summarised in meta-forest plots; other outcomes were synthesised narratively.Results41 systematic reviews incorporating data from 459 unique RCTs in diverse socio-economic and ethnic communities across 33 countries were included. R-AMSTAR quality score ranged from 20 to 42 (maximum 44). Apart from one outlier, the majority of reviews found an HbA1c improvement between 0.2% and 0.6% (2.2–6.5 mmol/mol) at 6 months post-intervention, but attenuated at 12 and 24 months. Impact on secondary outcomes was inconsistent and generally non-significant. Diverse self-management support strategies were employed; no single approach appeared optimally effective (or ineffective). Effective programmes tended to be multi-component and provide adequate contact time (>10 hours). Technology-facilitated self-management support showed a similar impact as traditional approaches (HbA1c MD −0.21% to −0.6%).ConclusionsSelf-management interventions using a range of approaches improve short-term glycaemic control in people with type 2 diabetes including culturally diverse populations. These findings can inform researchers, policy-makers and healthcare professionals re-evaluating the provision of self-management support in routine care. Further research should consider implementation and sustainability.

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