The Look After Yourself (LAY) intervention to improve self-management in stroke survivors: Results from a quasi-experimental study

Rossella Messina; Laura Dallolio; Stefania Fugazzaro; Paola Rucci; Marica Iommi; Roberta Bardelli; Stefania Costi; Monica Denti; Monia Allisen Accogli; Enrica Cavalli; Donatella Pagliacci; Maria Pia Fantini; Mariangela Taricco; LAY Project

doi:10.1016/j.pec.2020.01.004

The Look After Yourself (LAY) intervention to improve self-management in stroke survivors: Results from a quasi-experimental study

Patient Educ Couns. 2020 Jun;103(6):1191-1200. doi: 10.1016/j.pec.2020.01.004. Epub 2020 Jan 20.

Affiliations

¹ Department of Biomedical and Neuromotor Sciences, Section of Hygiene and Biostatistics, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
² Department of Biomedical and Neuromotor Sciences, Section of Hygiene and Biostatistics, Alma Mater Studiorum-University of Bologna, Bologna, Italy. Electronic address: laura.dallolio@unibo.it.
³ Physical Medicine and Rehabilitation Unit-Local Health Authority-IRCCS of Reggio Emilia, Reggio-Emilia, Italy.
⁴ Advanced School for Health Policy-Specialisation School for Public Administration, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
⁵ Department of Surgery, Medicine, Dentistry and Morphological Sciences-University of Modena and Reggio-Emilia, Modena, Italy; Scientific Directorate-Local Health Authority-IRCCS of Reggio-Emilia, Reggio-Emilia, Italy.
⁶ University Hospital Authority St. Orsola-Malpighi Polyclinic, Bologna, Italy.
⁷ Department of Community Health Care Agency USL Tuscany, Northwest, Pisa, Italy.

PMID: 31982203
DOI: 10.1016/j.pec.2020.01.004

Abstract

Objective: To test the efficacy of a self-management intervention for stroke survivors vs. usual care.

Methods: Using a quasi-experimental study, participants were recruited from three public Italian hospitals. Questionnaires assessing self-efficacy (SSEQ), quality of life (SF-12), physical performance (SPPB), depression (GDS) and activities of daily living (MBI) were administered at baseline, discharge and two months after discharge. Mixed models with a propensity score were used between experimental group (EG) and control group (CG). Logistic models were used to compare the use of health services.

Results: Eighty-two stroke survivors were enrolled in the EG and 103 in the CG. Self-efficacy in self-management improved in the EG compared to the CG during hospitalization. Improvements from baseline to discharge were found in the EG in the mental component of SF-12 and in MBI. The EG were 8.9 times more likely to contact general practitioners after discharge and 2.9 times to do regular exercise than CG. Notably, EG with higher education benefitted more from the intervention.

Conclusion: The intervention was efficacious in improving self-efficacy, mental health and activities of daily living.

Practice implications: Structured educational interventions based on problem-solving and individual goal setting may improve self-management skills in stroke survivors.

Keywords: Activities of daily living; Patient education; Quality of life; Self-efficacy; Self-management; Stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Humans
Quality of Life
Self-Management*
Stroke Rehabilitation*
Stroke* / therapy
Survivors