Objectives: To assess the impact of information packs on patients with stroke and their carers, and to pilot some of the methodology for a trial of a Family Support Organiser (FSO).
Subjects: Seventy-one patients admitted to Oxford hospitals with acute stroke during February–July 1995, and 49 informal carers of these patients.
Design: Randomized controlled trial. Intervention group received an information pack containing various Stroke Association publications one month after their stroke, or at discharge from hospital, whichever was sooner. Control group received nothing. Follow-up was by interview at the place of residence of the patients six months after their stroke.
Measures: Outcome measures assessed knowledge about stroke; satisfaction with information received; patient behaviour in terms of access to community services and benefits; and health status and quality of life.
Results: Patients and carers in the intervention group tended to know more about stroke, but these differences were not significant once adjusted for age. Patients in the intervention group (but not carers) tended to be more satisfied with the information that they had received, but the differences were not significant. There were no differences with regard to any aspects of quality of life in patients in the intervention group, though carers in the intervention group were found to have significantly better mental health (p = 0.04).
Conclusions: While the study was too small to generate firm conclusions, information leaflets may lead to improved knowledge about stroke several months after they have been distributed. This finding is worth following up with larger studies. The stroke knowledge questionnaire that was piloted in this trial seems to be able to detect differences between groups.
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References
1.
King's Fund Consensus Statement. Treatment of stroke. BMJ1988; 297: 126–128.
2.
Dennis M, O'Rourke S, Slattery J, Staniforth T, Warlow C. Evaluation of a stroke family care worker: results of a randomized controlled trial. BMJ1997; 314: 1071–1076.
3.
Wellwood I, Dennis MS, Warlow CP. Perceptions and knowledge of stroke among surviving patients with stroke and their carers. Age Ageing1994; 23: 293–298.
4.
Greveson G, James O. Improving long-term outcome after stroke – the views of patients and carers. Health Trends1991; 23: 161–162.
5.
van Veenendaal H, Grinspun DR, Adriaanse HP. Educational needs of stroke survivors and their family members, as perceived by themselves and by health professionals. Patient Educ Counseling1996; 28: 265–276.
6.
O'Mahoney PG, Rodgers H, Thomson RG, Dobson R, James OFW. Satisfaction with information and advice received by stroke patients. Clin Rehabil1997; 11: 68–72.
7.
Mant J, Mant F, Winner S. How good is routine information? Validation of coding for acute stroke in Oxford hospitals. Health Trends1998; 29: 96–99.
8.
Bamford J, Sandercock P, Dennis M et al. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86. 1. Methodology, demography and incident cases of first ever stroke. J Neurol Neurosurg Psychiatry1988; 51: 1373–1380.
9.
Pound P, Gompertz P, Ebrahim S. Patients' satisfaction with stroke services. Clin Rehabil1994; 8: 7–17.
10.
Pound P, Gompertz P, Ebrahim S. Development and results of a questionnaire to measure carer satisfaction after stroke. J Epidemiol Community Health1993; 47: 500–505.
11.
Harwood RH, Gompertz P, Ebrahim S. Handicap one year after stroke: validity of a new scale. J Neurol Neurosurg Psychiatry1994; 57: 825–829.
12.
Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand1983; 67: 361–370.
13.
Rowan K. Global questions and scores. In Jenkinson C ed. Measuring health and medical outcomes. London: UCL Press, 1994.
14.
Robinson BC. Validation of a caregiver strain index. J Gerontol1983; 38: 344–348.
15.
Jenkinson C, Coulter A, Wright L. Short form 36 Health Survey Questionnaire: Normative data for adults of working age. BMJ1993; 306: 1437–1440.
16.
Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability?Int Disabil Studies1988; 10: 64–67.
17.
Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst1959; 22: 719–748.
18.
Altman DG. Practical statistics for medical research. London: Chapman & Hall, 1991: 194–196.
19.
Montgomery EB Jr., Lieberman A, Singh G, Fries JF. Patient education and health promotion can be effective in Parkinson's disease: a randomized controlled trial. Am J Med1994; 97: 429–435.
20.
Fries JF, Carey C, McShane DJ. Patient education in arthritis: randomized controlled trial of a mail-delivered program. J Rheumatol1997; 24: 1378–1383.
21.
Lomer M, McLellan DL. Informing hospital patients and their relatives about stroke. Clin Rehabil1987; 1: 33–37.
22.
Pain HSB, McLellan DL. The use of individualized booklets after a stroke. Clin Rehabil1990; 4: 265–272.
