Development, Implementation And Evaluation Of Family-Based Educational Program On Nutrient Intake And Stroke Knowledge For First Ever Stroke Patients
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Date
2016-07
Authors
Sowtali, Siti Noorkhairina
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Stroke patients are at a higher risk of a secondary stroke attack if the modification of the risk factor is taken for granted. Therefore, it is important to carry out health education for the stroke patients and their family members to increase their knowledge about stroke. This study was carried out from October 2012 to September 2014. The purpose of this study is to develop, implement and evaluate the effectiveness of the IDEAS Program on the dietary status and stroke knowledge of first-time stroke patients during their rehabilitation phase. The first phase includes a preliminary study to assess the educational needs of stroke patients in Hospital Universiti Sains Malaysia (Hospital USM) using the Educational Needs on Stroke (ENS) instrument. In this phase, the translation and validation of the Stroke Knowledge Test (Malay version) instrument were also conducted with the 41 stroke patients studied. The second phase was a cross-sectional survey among 178 stroke patients in Hospital Raja Perempuan Zainab II (HRPZ II) to obtain a comprehensive data on dietary status information, anthropometric details and knowledge on stroke. Based on the findings from the first and second phase, two books entitled ‘Understand and Prevent Stroke’ and ‘Dietary Management after Stroke’ together with the IDEAS Program educational guideline were developed and validated. An intervention study was then carried out among stroke patients in HRPZ II whereby 31 of them were included in the intervention group. Meanwhile, 34 other patients were included in the control group. The intervention group had received standard
follow-ups as scheduled by the hospital, home visits, a one-to-one educational approach, phone monitoring and two books for reference. Meanwhile, the control group had only received follow-ups as scheduled by the hospital and home visits. Evaluation after 1 month (T1) and 3 months (T2) of stroke education were carried out in post-intervention for both groups. Findings from phase one found that stroke patients required education on stroke prevention (92.7%), causes of stroke (87.8%), risk factor modification-hypercholesterolemia (82.9%), chances of cure via medication (92.7%), fish intake (78.0%) and vegetable intake (78.0%). Validation study of the Stroke Knowledge Test (Malay version) instrument which consisted of 20 items had a moderate internal consistency (KR20=0.58). Findings from the second phase revealed that stroke patients with one morbidity (risk factor) had nine times better knowledge on stroke. The books ‘Understand and Prevent Stroke’ and ‘Dietary Management after Stroke’ showed good content validation index (CVI=0.901). Through repeated measurement via ANOVA analysis in phase three, the intervention group had scored higher than the control group at 3 months in the knowledge test (F=73.33, p=0.001), carbohydrate intake (F=11.58, p=0.001) and cholesterol intake (F=4.94, p=0.030) at the recommended range. In conclusion, the utilization of IDEAS Program is effective to increase the knowledge level and dietary patterns of the stroke patients.
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Keywords
Development, implementation and evaluation , first ever stroke patients.