Effectiveness of a stepped self-care program for stroke survivors: A quasi-experimental study.
Zihao Ruan, Dan Wang, Wenna Wang and 5 others
PMID 41684614WHAT IT FOUND
Stroke survivors who received stepped self-care scored higher on self-care, self-efficacy, and quality of life than the usual care group at all post-intervention checks.
The program used WeChat first, then face-to-face support.
Key findings
01Self-care scores were significantly higher in the stepped program group than the control group at every post-intervention check.
02Self-efficacy and quality of life were also significantly higher in the stepped program group at every post-intervention check.
03Participants advanced to a more intensive step only when their self-care scores did not reach the required threshold.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited from only two wards in a single hospital, so results may not generalise. Only two wards were allocated by coin flip, so cluster randomisation was very limited. Participants and outcome assessors were not blinded, and outcomes were self-reported. The analysis used only participants who completed the assigned intervention, so people who dropped out were not included in the main results. Attrition was 10.9% overall and 12.73% in the intervention group, mostly during the online steps. Follow-up was only 3 months, so long-term effects were not assessed. Eligibility required cognitive intactness, no significant communication disorder, partial self-care ability, and ability to use WeChat, so people outside these criteria were not studied.
Declared interests
Funding was provided by the National Natural Science Foundation of China, which provided policy and financial support. The authors declared no conflict of interest.
The easy way to misread this
Do not read this as evidence that WeChat alone improves stroke self-care. The stepped program also included pre-discharge education, WeChat knowledge messages, interactive WeChat sessions, and face-to-face home visits with caregivers.