Effects of a Goal-Oriented Intervention on Self-Management Behaviors and Self-Perceived Burden After Acute Stroke: A Randomized Controlled Trial

Abstract

Background: Stroke generates significant health and social burdens. Self-management has potential importance for supporting individuals in coping and continuing to progress after stroke. However, there is a lack of targeted programs to enhance self-management and reduce self-perceived burden (SPB) following stroke.Purpose: To evaluate the effects of a goal-oriented intervention on self-management behaviors and SPB among patients after acute stroke.Methods: This was a randomized controlled trial with a 4-weeks intervention. Participants were randomly allocated to the intervention (n = 48) or control group (n = 48). The intervention and control groups received eight sessions of goal-oriented self-management intervention based on Pender's health promotion model and control care, respectively. Self-management behaviors and SPB were evaluated and compared between the two groups.Results: After the 1-month follow-up, there were significant differences in the total self-management behaviors score and the scores of six of the self-management dimensions, excluding diet management, between the intervention group and the control group (t = −7.891– −2.815; p ≤ 0.006). Compared to the control group, the intervention group showed a significant decrease in the physical burden, emotional burden, and total SPB scores (t = 2.102–2.071; p = 0.015–0.041). The economic burden score was not significantly different between the two groups (t = 1.707; p = 0.091).Conclusion: The goal-oriented intervention based on Pender's health promotion model can effectively improve self-management behaviors and reduce physical and emotional SPB among stroke survivors.

The mediating effect of stigma between self-perceived burden and loneliness in stroke patients

“…In addition, people with high self-perceived burden are particularly sensitive to relying on others and exhibit decreased contact, leading to increased loneliness ( 15 ). In addition, most stroke patients have physical dysfunctions and require assistance with daily living activities, which may lead to feelings of guilt and burden, and thus increase their self-perceived burden ( 21 , 35 ). In traditional Chinese culture, loss of self-care ability and dependence on others in daily life may cause patients to develop thoughts of uselessness, a reduced sense of self-worth, and worry about becoming a burden to the entire family ( 28 ).…”

“…Most stroke patients return home after stabilization for financial reasons, and failure to receive professional stroke rehabilitation after discharge may lead to poor physical function. Stroke survivors receiving care from others, especially those with functional impairment, demonstrate self-perceived burden ( 21 ). Influenced by Confucianism and the core values of collectivism, Chinese people regard caring for family members as an obligation.…”

Effect of high-quality nursing on neurological function psychological moods quality of life of elderly patients with stroke

“…⑤ Self-perceived burden: The Self-Perceived Burden Scale (SPBS) was applied post-intervention to gauge the patients' subjective perception of burden across physical, emotional, and financial dimensions ( 17 ). The instrument incorporates 10 scored items, cumulatively amounting to a maximum of 50 points; a higher score underscores elevated self-perceived burden.…”

A meta‐analysis of studies of the effects of case management intervention for stroke survivors across three countries

“…Stroke is the leading cause of death and disability worldwide (Campbell & Khatri, 2020) and is associated with considerable personal, family, and societal burdens, including high economic and social costs (Chen, Wei, et al, 2021; Wang et al, 2021). In 2019, approximately 101.5 million people were estimated to be living with stroke, and stroke was responsible for over 6.6 million deaths worldwide (Alonso et al, 2021; Virani et al, 2021).…”