Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study

Abstract

Jones, K. M. et al. (2018) Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study. Clinical Rehabilitation, (doi:10.1177/0269215518777565).There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/163319/ Objective: To assess the feasibility of conducting a randomised controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multi-national context.Design: Non-funded, pilot randomised controlled trial of intervention versus usual care.Setting: International, multi-centre, community-based. Participants:Community living adults up to 3-years post-stroke with moderate-tosevere disability and their nominated informal caregivers. Interventions:Intervention patients viewed and practiced rehabilitation techniques demonstrated in the DVD over 6-weeks. Main measures:Trial feasibility by number of active recruitment sites, recruitment efficiency, randomisation and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life -5-level EQ-5D health status measure, General Health Questionnaire, and Centre for Epidemiological StudiesDepression at 2-months.Results: Fourteen recruitment sites were established across 8 countries. Recruitment was achieved at nine (64%) sites. Over 16-months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomised to intervention (n = 34) and control (n = 32) groups. Fifty-four (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were 7 mixed. There were no significant between-group differences in outcomes at 2-months (p >0.05). Conclusions:Conducting a multi-national trial of a stroke DVD requires full funding. However, interventions aimed at improving this care provide evidence that educational needs are highly complex. 5,6 Effective and feasible learning tools to teach patients and their family caregivers how to cope with common problems following stroke and to support active recovery as an international standard of care remain elusive. Although there has been extensive research in this area, most studies are focussed on the early discharge period within a single country and incorporate use of face-to-face delivery alone or combined face-to-face and telephone-based treatments. 5,6 Less is known about the potential efficacy of other modes of delivery on a more global perspective. 10 We developed an instructional and educational home-based intervention specifically focused on common problems encountered by patients following stroke and their caregivers to be used in culturally and geographic diverse regions.This multi-national randomised controlled trial was conducted to compare the intervention delivered by DVD and standar...

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“…In the studies from search 2, models were predominantly selected according to the target population of the respective intervention. For example, actors in videos represented parents when the intervention targeted parents ( Black and Teti, 1997 ; Ledoux et al, 2018 ), and models were patients when the intervention was aimed at patients ( Maddison et al, 2008 ) or caregivers ( Jones et al, 2018 ). In one study on type 1 diabetes, videos were even developed and shot involving the affected individuals themselves ( Massouh et al, 1989 ), creating maximum congruence between model and observer.…”

Use of Self-management Module via Video-Based Education for Stroke Survivors and Their Caregivers: A Narrative Review of Literature

“…[7][8][9] Jones KM et al (2018) mentioned that the most common barrier to accessing video based intervention was a misalignment between the needs of the survivors of stroke with the content of their intervention and potential barriers that impede learning may include cognitive, language, cultural and hearing deficits. 12…”

Anthology of stroke epidemiology in the 20th and 21st centuries: Assessing the past, the present, and envisioning the future

“…In this respect, there is a growing support from health professionals 70 Table 1. Criteria for basic and advanced population-based stroke and TIA incidence studies (adapted from Feigin et al, 60 efficacy, 70,71 and ideally they should be available for patients and their families for free, such as those recently released by the New Zealand Stroke Education Charitable Trust for people of Singapore (arrangements with other countries are currently in place). With all these research and practical advances in stroke epidemiology, prevention, management, and rehabilitation, I do believe that the ambitious WSO mission to reduce the global burden of stroke will be achieved.…”

“…UK Stroke Association [Ms Sandra Jackson, personal communication], Stroke Alliance for Europe [Ms Jelena Misita, personal communication]) for the development and implementation of self-management on-line video rehabilitation tools that can be easily accessed and used by the patients and their family members at any place and any time they need it. Several such tools are already available and have demonstrated their preliminary efficacy, 70,71 and ideally they should be available for patients and their families for free, such as those recently released by the New Zealand Stroke Education Charitable Trust for people of Singapore (arrangements with other countries are currently in place).…”