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Information provision for stroke patients and their caregiversSmith J, Forster A, House A, Knapp P, Wright JJ, Young J SummaryInformation provision for stroke patients and their caregiversStudies have shown that stroke survivors and their carers often feel they have not been given enough information about stroke and feel unprepared for life after discharge from hospital. However, the best way to provide information after stroke is unclear. The authors of this review looked at the evidence for the effectiveness of providing information to patients, or carers of patients, who have had a stroke or transient ischaemic attack (TIA), sometimes called a mini-stroke. They examined randomised trials (studies) in which one group of stroke patients or carers who were given the intervention being tested (such as a course of lectures) was compared with a group of stroke patients or carers who received standard care. Seventeen studies, involving 1773 patients and 1058 carers, were included in the review. Overall, the studies showed that providing information to patients and carers improved their knowledge of stroke and increased patient satisfaction with some, but not all, of the information they received about stroke. There was also an effect on reducing patient depression, although the reduction was small and would probably not be enough to seem meaningful to patients. When information was provided in a way that more actively involved patients and carers, for example by offering repeated opportunities to ask questions, it had more effect on patient mood than information which was given on one occasion only. There is not much evidence that providing information had effects on other aspects of patient or carer stroke recovery such as independence or social activities.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
July 23. 2001 AbstractBackgroundResearch shows that stroke patients and their families are dissatisfied with the information provided and have a poor understanding of stroke and associated issues. ObjectivesTo assess the effectiveness of information provision strategies in improving the outcome for stroke patients and/or their identified caregivers. Search strategyWe searched the Cochrane Stroke Group Trials Register (last searched May 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2007), MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007), CINAHL (1982 to March 2007), PsycINFO (1974 to March 2007), Science Citation Index and Social Science Citation Index (1981 to March 2007), Assia (1987 to March 2007), Index to UK theses (1970 to March 2007), Dissertation Abstracts (1961 to March 2007), ongoing trials and research registers, bibliographies of retrieved papers, relevant articles and books, and the Journal of Advanced Nursing. We also contacted researchers for additional information. Selection criteriaRandomised trials involving patients or carers of patients with a clinical diagnosis of stroke or transient ischaemic attack (TIA) where an information intervention was compared with standard care, or where information and another therapy were compared with the other therapy alone. Data collection and analysisTwo review authors independently assessed trial eligibility and methodological quality and extracted data. Primary outcomes were knowledge about stroke and stroke services, and impact on mood. Main resultsSeventeen trials involving 1773 patient and 1058 carer participants were included. Eight evaluated a passive and nine an active information intervention. Meta-analyses showed a significant effect in favour of the intervention on patient and carer knowledge, one aspect of patient satisfaction, and patient depression scores. There was no significant effect on number of cases of anxiety or depression in patients, carer mood or satisfaction, or death. Qualitative analyses found no strong evidence of an effect on other outcomes. Post-hoc subgroup analyses showed that active information had a significantly greater effect than passive information on patient mood but not on other outcomes. Authors' conclusionsThere is evidence that information improves patient and carer knowledge of stroke, aspects of patient satisfaction, and reduces patient depression scores. However, the reduction in depression scores was small and probably clinically insignificant. Although the best way to provide information is still unclear there is some evidence that strategies that actively involve patients and carers and include planned follow up for clarification and reinforcement have a greater effect on patient mood. |