Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2020

Open Access 01-12-2020 | Stroke | Study protocol

A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial

Authors: Shuanglan Lin, Lily Dongxia Xiao, Diane Chamberlain

Published in: Trials | Issue 1/2020

Login to get access

Abstract

Background

Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care.

Methods

This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as “participant dyads”, and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcome is changes in self-efficacy of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors’ and quality of life, functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers’ self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline.

Discussion

This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers.

Trial registration

The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000321​145. Registered on 1 March 2019.
Appendix
Available only for authorised users
Literature
1.
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245–55.PubMedPubMedCentral
2.
Yu SC, Tan F, Zhou MG, Liu SW, Zhu XJ, Zhu YL. Global Burden of Disease, Injury and Risk Factor Study 2010: its policy implications for China. Biomed Environ Sci. 2014;27(1):45–8.PubMed
3.
Wang L, Wang J, Peng B, Xu Y. 《中国脑卒中防治报告2016》概要. 中国脑血管病杂志. 2017;14(4):217–24.
4.
Wang Y, Liu M, Cq P, Association NboCM. 中国缺血性脑卒中和短暂性脑缺血发作二级预防指南 2014. Chin J Neurol. 2015;48(4):258–73.
5.
Vloothuis J, Mulder M, Nijland RH, Konijnenbelt M, Mulder H, Hertogh CM, et al. Caregiver-mediated exercises with e-health support for early supported discharge after stroke (CARE4STROKE): study protocol for a randomized controlled trial. BMC Neurol. 2015;15:193.PubMedPubMedCentral
6.
Araujo O, Lage I, Cabrita J, Teixeira L. Intervention in informal caregivers who take care of older people after a stroke (InCARE): study protocol for a randomised trial. J Adv Nurs. 2015;71(10):2435–43.PubMed
7.
Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Global Health. 2018;6(11):E1196–E252.PubMed
8.
World Health Organization. Integrated care for older people: Guidelines on community-level interventions to manage declines in intrinsic capacity. Geneva: World Health Organization; 2017.
9.
Cameron JI, Naglie G, Silver FL, Gignac MA. Stroke family caregivers’ support needs change across the care continuum: a qualitative study using the timing it right framework. Disabil Rehabil. 2013;35(4):315–24.PubMed
10.
Jiaojiao B, Wenqun C, Jinyu Z, Xu Y, Shen X, Xiaorong G, et al. Investigation on attending demand of main home caregivers of cerebral apoplexy patients (脑卒中主要居家照顾者照顾需求的调查研究). Family Nurse. 2008;6(4):855–8.
11.
Wang J, Wang L, Yiran J, Guo X, He W, Lin H, et al. The practice of “hospital-community-home” transitional care for stroke patients in family doctor services (脑卒中患者"医院-社区-居家"延续照护模式在家庭医生式服务中的实践). Chin Nursing Manag. 2017;17(4):448–52.
12.
Yan LL, Li C, Chen J, Miranda JJ, Luo R, Bettger J, et al. Prevention, management, and rehabilitation of stroke in low- and middle-income countries. eNeurologicalSci. 2016;2:21–30.PubMedPubMedCentral
13.
Guo YL, Liu YJ. Family functioning and depression in primary caregivers of stroke patients in China. Int J Nursing Sci. 2015;2(2):184–9.
14.
Loh AZ, Tan JS, Zhang MW, Ho RC. The Global Prevalence of Anxiety and Depressive Symptoms Among Caregivers of Stroke Survivors. J Am Med Dir Assoc. 2017;18(2):111–6.PubMed
15.
Jaracz K, Grabowska-Fudala B, Gorna K, Jaracz J, Moczko J, Kozubski W. Burden in caregivers of long-term stroke survivors: Prevalence and determinants at 6 months and 5 years after stroke. Patient Educ Couns. 2015;98(8):1011–6.PubMed
16.
Godwin KM, Ostwald SK, Cron SG, Wasserman J. Long-term health-related quality of life of stroke survivors and their spousal caregivers. J Neurosci Nurs. 2013;45(3):147–54.PubMedPubMedCentral
17.
Camicia M, Black T, Farrell J, Waites K, Wirt S, Lutz B, et al. The essential role of the rehabilitation nurse in facilitating care transitions: a white paper by the association of rehabilitation nurses. Rehabil Nurs. 2014;39(1):3–15.PubMed
18.
Wolever R, Simmons L, Sforzo G, Dill D, Kaye M, Bechard E, et al. A Systematic Review of the Literature on Health and Wellness Coaching: Defining a Key Behavioral intervention in Healthcare. Glob Adv Health Med. 2013;2(4):38–57.PubMedPubMedCentral
19.
Barakat S, Boehmer K, Abdelrahim M, Ahn S, Al-Khateeb AA, Villalobos NA, et al. Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. Popul Health Manag. 2018;21(1):63–81.PubMed
20.
Dejonghe LAL, Becker J, Froboese I, Schaller A. Long-term effectiveness of health coaching in rehabilitation and prevention: A systematic review. Patient Educ Couns. 2017;100:1643–53.PubMed
21.
Chenoweth L, Stein-Parbury J, White D, McNeill G, Jeon YH, Zaratan B. Coaching in self-efficacy improves care responses, health and well-being in dementia carers: a pre/post-test/follow-up study. BMC Health Serv Res. 2016;16:166.PubMedPubMedCentral
22.
Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of health coaching on adult patients with chronic diseases-a systematic review. Patient Educ Couns. 2014;97(2):147–57.PubMed
23.
Wong-Rieger D, Rieger FP. Health Coaching in Diabetes: Empowering Patients to Self-Manage. Can J Diabetes. 2013;37(1):41–4.
24.
Yanhong Z, Liang W, Zhu L, Jingsong Y. 简明精神状态量表和蒙特利尔认知评估量表的比较. Chin J Rehabil Med. 2012;27(5):431–6.
25.
Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd M, Carlsen EB, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. BMC Health Serv Res. 2013;13:428.PubMedPubMedCentral
26.
Panagioti M, Reeves D, Meacock R, Parkinson B, Lovell K, Hann M, et al. Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? An evaluation of reach, effectiveness and cost-effectiveness using a ‘trial within a cohort’. BMC Med. 2018;16:80.PubMedPubMedCentral
27.
Riazi A, Aspden T, Jones F. Stroke Self-efficacy Questionnaire: a Rasch-refined measure of confidence post stroke. J Rehabil Med. 2014;46(5):406–12.PubMed
28.
Guo QY, Guo MJ, Zhang L, Guo LN, Gao H, Chen YQ, et al. 脑卒中患者自我效能问卷中文版的信效度研究. Chin J Behav Med & Brain Sci. 2015;24(3):273–5.
29.
Post MW, Boosman H, van Zandvoort MM, Passier PE, Rinkel GJ, Visser-Meily JM. Development and validation of a short version of the Stroke Specific Quality of Life Scale. J Neurol Neurosurg Psychiatry. 2011;82(3):283–6.PubMed
30.
Zhang X, Bi S, Zhang S, Zhang H, Huo J. 扩展Barthel指数量表评定脑卒中ADL能力的效度研究(Validity of Extended Barthel Index for Assessing Stroke ADL Ability). Chin J Rehabil. 2019;34(3):134–7.
31.
Hsueh I-P, Lin J-H, Jeng J-S, Hsieh C-L. Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with stroke. J Neurol Neurosurg Psychiatry. 2002;73:188–90.PubMedPubMedCentral
32.
Hou D, Zhang Y, Wu J, Li Y, An Z. 中文版Barthel指数的信度与效度研究(Study on reliability and validity of Chinese version of Barthel Index). Chinical Focus. 2012;27(3):219–21.
33.
Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9(3):179–86.PubMed
34.
Ran L, Jiang X, Li B, Kong H, Du M, Wang X, et al. Association among activities of daily living, instrumental activities of daily living and health-related quality of life in elderly Yi ethnic minority. BMC Geriatr. 2017;17(1):74.PubMedPubMedCentral
35.
Wang J, Xiao LD, He GP, Ullah S, De Bellis A. Factors contributing to caregiver burden in dementia in a country without formal caregiver support. Aging Ment Health. 2014;18(8):986–96.PubMed
36.
Sy X. 社会支持评定量表 (Social spport rating scale). In: Wang XD, Wang XL, Ma H, editors. 心理卫生评定量表手册(Rating scales for mental health). Beijing: Chinese Mental Health Journal Publishing; 1999. p. 127–31.
37.
Wan LH, Zhao J, Zhang XP, Deng SF, Li L, He SZ, et al. Stroke prevention knowledge and prestroke health behaviors among hypertensive stroke patients in mainland China. J Cardiovasc Nurs. 2014;29(2):E1–9.PubMed
38.
Lv L, Guo H, Hu L, Liu Q, Xu X. 脑卒家庭照顾者自我效能与照顾能力状况及其相关性. Modern Clin Nursing. 2016;15(8):6–10.
39.
Schwarzer R, BaBler J, Kwiatel P, Schroder K. The Assessment of Optimistic Self-beliefs: Comparison of the German, Spanish, and Chinses Versions of the General Self-efficacy Scale. Appl Psychol. 1997;46(1):69–88.
40.
Travis SS, Bernard MA, Mcauley WJ, Thornton M, Kole T. Development of the Family Caregiver Medication Administration Hassles Scale. The Gerontologist. 2003;43(3):360–8.PubMed
41.
Chan WCH, Chan CLF, Suen M. Validation of the Chinese Version of the Modified Caregivers Strain Index among Hong Kong Caregivers: An Initiative of Medical Social Workers. Health Social Work. 2013;38(4):214–21.PubMed
42.
Lo SHS, Chang AM, Chau JPC. Stroke Self-Management Support Improves Survivors’ Self-Efficacy and Outcome Expectation of Self-Management Behaviors. Stroke. 2018;49(3):758–60.PubMed
43.
44.
Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.PubMed
45.
Hill B, Richardson B, Skouteris H. Do we know how to design effective health coaching interventions: a systematic review of the state of the literature. Am J Health Promot. 2015;29(5):e158–68.PubMed
46.
Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol Health. 2011;26(11):1479–98.PubMed
47.
Wang L. 中国脑卒中防治工程的现状与未来(Prevention and treatment of stroke in China: the status and future). Acad J Second Military Univ. 2018;39(9):941–3.
48.
Yu CH, Luo LS, Li M, Yu JH, Meng RT, Yuan RX. 从全球视角看中国脑卒中疾病负担的严峻性(From the global views to understand the seriousness of the burden of stroke in China). J Public Health Prev Med. 2016;27(1):1–5.
49.
Benzo RP, Kirsch JL, Hathaway JC, McEvoy CE, Vickers KS. Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study. Respir Care. 2017;62(11):1403–11.PubMedPubMedCentral
50.
Thom DH, Wolf J, Gardner H, DeVore D, Lin M, Ma A, et al. A Qualitative Study of How Health Coaches Support Patients in Making Health-Related Decisions and Behavioral Changes. Ann Fam Med. 2016;14(6):509–16.PubMedPubMedCentral
51.
Wallace AM, Bogard MT, Zbikowski SM. Intrapersonal Variation in Goal Setting and Achievement in Health Coaching: Cross-Sectional Retrospective Analysis. J Med Internet Res. 2018;20(1):e32.PubMedPubMedCentral
52.
Xing Y, Yang SD, Dong F, Wang MM, Feng YS, Zhang F. The beneficial role of early exercise training following stroke and possible mechanisms. Life Sci. 2018;198:32–7.PubMed
53.
Simpson D, Callisaya ML, English C, Thrift AG, Gall SL. Self-Reported Exercise Prevalence and Determinants in the Long Term After Stroke: The North East Melbourne Stroke Incidence Study. J Stroke Cerebrovasc Dis. 2017;26(12):2855–63.PubMed
54.
de Sousa DG, Harvey LA, Dorsch S, Glinsky JV. Interventions involving repetitive practice improve strength after stroke: a systematic review. J Physiother. 2018;64(4):210–21.PubMed
55.
Keith RE, Hopp FP, Subramanian U, Wiitala W, Lowery JC. Fidelity of implementation: development and testing of a measure. Implementation Sci. 2010;5:99.
56.
Mars T, Ellard D, Carnes D, Homer K, Underwood M, Taylor SJ. Fidelity in complex behaviour change interventions: a standardised approach to evaluate intervention integrity. BMJ Open. 2013;3(11):e003555.PubMedPubMedCentral
Metadata
Title
A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial
Authors
Shuanglan Lin
Lily Dongxia Xiao
Diane Chamberlain
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Stroke
Care
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-020-4156-z

Other articles of this Issue 1/2020

Trials 1/2020 Go to the issue

Study protocol

Protocol for the Process Evaluation of the Online Remote Behavioural Intervention for Tics (ORBIT) randomized controlled trial for children and young people

Study protocol

My Bridge (Mi Puente), a care transitions intervention for Hispanics/Latinos with multimorbidity and behavioral health concerns: protocol for a randomized controlled trial

Letter

CytoResc – “CytoSorb” Rescue for critically ill patients undergoing the COVID-19 Cytokine Storm: A structured summary of a study protocol for a randomized controlled trial

Study protocol

Effects of moving cupping therapy for plaque psoriasis: study protocol for a randomized multicenter clinical trial

Study protocol

Intense versus standard regimens of intermittent occlusion therapy for unilateral moderate amblyopia in children: study protocol for a randomized controlled trial

Study protocol

A novel human laboratory model for screening medications for alcohol use disorder