학술논문

Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study.
Document Type
Article
Source
Clinical Rehabilitation. Aug2018, Vol. 32 Issue 8, p1086-1097. 12p. 1 Diagram, 5 Charts.
Subject
*QUALITY of life
*CAREGIVERS
*CHI-squared test
*CLINICAL trials
*MEDICAL cooperation
*PATIENT education
*PROBABILITY theory
*PSYCHOLOGICAL tests
*QUESTIONNAIRES
*RESEARCH
*RESEARCH funding
*STATISTICAL sampling
*STATISTICAL hypothesis testing
*DVD-Video discs
*PILOT projects
*RANDOMIZED controlled trials
*BURDEN of care
*TREATMENT effectiveness
*PRE-tests & post-tests
*INDEPENDENT living
*DATA analysis software
*PATIENTS' attitudes
*STROKE rehabilitation
*DESCRIPTIVE statistics
Language
ISSN
0269-2155
Abstract
Objective: To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. Design: Non-funded, pilot randomized controlled trial of intervention versus usual care. Setting: International, multicentre, community-based. Participants: Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers. Interventions: Intervention patients viewed and practised rehabilitation techniques demonstrated in the DVD over six weeks. Main measures: Trial feasibility by number of active recruitment sites, recruitment efficiency, randomization and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life -- 5-level EuroQol-5D (EQ-5D) health status measure, General Health Questionnaire and Centre for Epidemiological Studies--Depression at two months. Results: In total, 14 recruitment sites were established across eight countries. Recruitment was achieved at nine (64%) sites. Over 16 months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomized to intervention (n = 34) and control (n = 32) groups. In total, 54 (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were mixed. There were no significant between-group differences in outcomes at two months (P > 0.05). Conclusion: Conducting a multinational trial of a stroke DVD requires full funding. The intervention was acceptable to some patients and their caregivers, yet a generalized education approach did not fully meet their needs and/or expectations. A more individualized method may be required to meet peoples' changing needs during stroke recovery. [ABSTRACT FROM AUTHOR]