Background: Recovery after stroke is long-term and demanding. Optimising community-residing stroke survivors�\ncapability to self-manage their health is integral. Recent systematic reviews have shown that stroke selfmanagement\nprogrammes were associated with significant improvement in stroke survivors� health-related quality\nof life and self-efficacy. However some programmes were not designed with an underpinning theoretical\nframework. The aim of this study is to compare the effectiveness of a nurse-led stroke self-management\nprogramme with usual care on recovery of community-residing stroke survivors.\nMethods/Design: A single-blinded, two-arm, randomised controlled trial will be conducted. Patients with a history of\nfirst or recurrent ischaemic or haemorrhagic stroke who will be discharged to home settings will be recruited from\nacute stroke units of three acute public hospitals in Hong Kong. The estimated sample size is 160 (80 participants per\ngroup). Eligible participants will be randomised to receive either usual care or a 4-week nurse-led community-based\nself-management programme plus usual care after discharge. The programme, underpinned by Bandura�s constructs of\nself-efficacy and outcome expectation, includes one individual home visit, two community-based group sessions, and\nthree follow-up phone calls. Primary outcomes include stroke survivors� self-efficacy and outcome expectation of\nperforming self-management behaviours. Secondary outcomes include health-related quality of life, satisfaction with\nperformance of self-management behaviours, depressive symptoms, and community reintegration. Participants will be\nassessed at baseline and at 8 weeks after randomisation. Generalised estimating equations will be performed to\nevaluate the significance of changes in outcomes over time by treatment condition. Research ethics approvals were\nobtained.\nDiscussion: It is expected that stroke survivors receiving the stroke self-management programme will have improved\nself-efficacy, outcome expectation, and performance of stroke self-management behaviours. Enhanced quality of life\nand level of community reintegration, and decreased depressive symptoms are also expected. The study results will\nprovide valuable evidence to inform future identification and evaluation of best approach to deliver stroke selfmanagement\nprogrammes to enhance community-residing stroke survivors� recovery.
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