J Korean Acad Nurs.  2014 Oct;44(5):581-591. 10.4040/jkan.2014.44.5.581.

Effectiveness of a Self-management Program using Goal Setting based on a G-AP for Patients after a Stroke

• Park MG
• Ha Y

• KMID: 2129548
• DOI: http://doi.org/10.4040/jkan.2014.44.5.581

Abstract

PURPOSE
This study was conducted to develop a self-management program using goal setting for patients after a stroke. The program was based on a theory-based Goal setting and Action Planning framework (G-AP), and the effectiveness of the program was examined.
METHODS
A non-equivalent control group pretest-posttest design was used. The experimental group (n=30) received the self-management program using goal setting based on the G-AP over 7 weeks. The education was delivered individually with a specifically designed stroke workbook. The control group (n=30) received only patient information leaflets about stroke.
RESULTS
There were significant differences between the two groups. Stroke knowledge, self-efficacy, and health behavior compliance were significantly higher (all p<.001), and hospital anxiety (p<.001) and depression (p<.001) were significantly lower in the experimental group compared to the control group.
CONCLUSION
This self-management program using goal setting based on a G-AP was found to be useful and beneficial for patients in stroke rehabilitation settings.

Keyword

Stroke; Goal setting; Self care; Self efficacy; Health behavior

MeSH Terms

Aged
Anxiety
Depression
Female
Health Behavior
Humans
Knowledge
Male
Middle Aged
Patient Compliance
*Program Evaluation
Questionnaires
*Self Care
Self Efficacy
Stroke/*psychology

Reference

1. Statistics Korea. Annual report on the cause of death statistics [Internet]. Daejeon: Author;2013. cited 2013 July 20. Available from:http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&aSeq=260046.

2. Korean Stroke Society. Stroke story [Internet]. Seoul: Author;2011. cited 2013 August 15. Available from: http://www.stroke.or.kr/stroke/stroke_con.php.

3. Jones F, Riazi A. Self-efficacy and self-management after stroke: A systematic review. Disabil Rehabil. 2011; 33(10):797–810. http://dx.doi.org/10.3109/09638288.2010.511415.

4. Lorig KR, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med. 2003; 26(1):1–7. http://dx.doi.org/10.1207/S15324796ABM2601_01.

5. Scottish Intercollegiate Guidelines Network. Management of patients with stroke: Rehabilitation, prevention and management of complications, and discharge planning. A national clinical guideline. Edinburgh, UK: NHS Quality Improvement Scotland;2010.

6. Intercollegiate Stroke Working Party. National clinical guideline for stroke. 4th ed. London, UK: Royal College of Physicians;2012.

7. Ajou University Industry Academic Cooperation Foundation. Development of clinical practice guideline for stroke rehabilitation in Korea. Cheongju: Korea Centers for Disease Control and Prevention;2012.

8. National Stroke Foundation. Clinical guidelines for stroke management 2010. Melbourne, AU: Author;2010.

9. Forster A, Brown L, Smith J, House A, Knapp P, Wright JJ, et al. Information provision for stroke patients and their caregivers. Cochrane Database Syst Rev. 2012; 11:CD001919. http://dx.doi.org/10.1002/14651858.CD001919.pub3.

10. Jones F, Riazi A, Norris M. Self-management after stroke: Time for some more questions. Disabil Rehabil. 2013; 35(3):257–264. http://dx.doi.org/10.3109/09638288.2012.691938.

11. Department of Health. The national stroke strategy. London, UK: DH;2007.

12. Hoffmann T, McKenna K, Worrall L, Read SJ. Randomised trial of a computer-generated tailored written education package for patients following stroke. Age Ageing. 2007; 36(3):280–286. http://dx.doi.org/10.1093/ageing/afm003.

13. Hackett ML, Anderson CS, House A, Halteh C. Interventions for preventing depression after stroke. Cochrane Database Syst Rev. 2008; 3:CD003689. http://dx.doi.org/10.1002/14651858.CD003689.pub3.

14. Shin ES, Hwang SY, Jeong MH, Lee ES. Relationships of factors affecting self-care compliance in acute coronary syndrome patients following percutaneous coronary intervention. Asian Nurs Res. 2013; 7(4):205–211. http://dx.doi.org/10.1016/j.anr.2013.10.003.

15. Lennon S, McKenna S, Jones F. Self-management programmes for people post stroke: A systematic review. Clin Rehabil. 2013; 27(10):867–878. http://dx.doi.org/10.1177/0269215513481045.

16. Levack WM, Taylor K, Siegert RJ, Dean SG, McPherson KM, Weatherall M. Is goal planning in rehabilitation effective? A systematic review. Clin Rehabil. 2006; 20(9):739–755. http://dx.doi.org/10.1177/0269215506070791.

17. Siegert RJ, Taylor WJ. Theoretical aspects of goal-setting and motivation in rehabilitation. Disabil Rehabil. 2004; 26(1):1–8. http://dx.doi.org/10.1080/09638280410001644932.

18. Scobbie L, Dixon D, Wyke S. Goal setting and action planning in the rehabilitation setting: Development of a theoretically informed practice framework. Clin Rehabil. 2011; 25(5):468–482. http://dx.doi.org/10.1177/0269215510389198.

19. Allen K, Hazelett S, Jarjoura D, Hua K, Wright K, Weinhardt J, et al. A randomized trial testing the superiority of a postdischarge care management model for stroke survivors. J Stroke Cerebrovasc Dis. 2009; 18(6):443–452. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2009.02.002.

20. Kang SM. An effect of the secondary stroke prevention education program on self-care of acute ischemic stroke patients [master's thesis]. Seoul: Konkuk University;2005.

21. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361–370. http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x.

22. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–296.

23. Kim CG, Park HA. Development and evaluation of a web-based education program to prevent secondary stroke. J Korean Acad Nurs. 2011; 41(1):47–60. http://dx.doi.org/10.4040/jkan.2011.41.1.47.

24. Lowe DB, Sharma AK, Leathley MJ. The carefile project: A feasibility study to examine the effects of an individualised information booklet on patients after stroke. Age Ageing. 2007; 36(1):83–89. http://dx.doi.org/10.1093/ageing/afl145.

25. Hafsteinsdóttir TB, Vergunst M, Lindeman E, Schuurmans M. Educational needs of patients with a stroke and their caregivers: A systematic review of the literature. Patient Educ Couns. 2011; 85(1):14–25. http://dx.doi.org/10.1016/j.pec.2010.07.046.

26. Jones F, Mandy A, Partridge C. Changing self-efficacy in individuals following a first time stroke: Preliminary study of a novel self-management intervention. Clin Rehabil. 2009; 23(6):522–533. http://dx.doi.org/10.1177/0269215508101749.

27. Johnston M, Bonetti D, Joice S, Pollard B, Morrison V, Francis JJ, et al. Recovery from disability after stroke as a target for a behavioural intervention: Results of a randomized controlled trial. Disabil Rehabil. 2007; 29(14):1117–1127. http://dx.doi.org/10.1080/03323310600950411.

28. Bandura A. Self-efficacy: The exercise of control. New York, NY: Worth Publishers;1997.

29. Taylor WJ, Brown M, William L, McPherson KM, Reed K, Dean SG, et al. A pilot cluster randomized controlled trial of structured goal-setting following stroke. Clin Rehabil. 2012; 26(4):327–338. http://dx.doi.org/10.1177/0269215511419384.

30. Jones F, Partridge C, Reid F. The stroke self-efficacy questionnaire: Measuring individual confidence in functional performance after stroke. J Clin Nurs. 2008; 17(7B):244–252. http://dx.doi.org/10.1111/j.1365-2702.2008.02333.x.