Development of a stroke prevention model for risk people in a tertiary hospital

Abstract

Stroke is an important preventable cause of death and long-term disability worldwide. This participatory action research (PAR) study aimed to develop a model for stroke prevention for Thai people who are at risk of stroke in a tertiary hospital. The model development consisted of six steps: 1) establishment of contacts and mutual commitments, 2) formation and enhancement of a core working group, 3) situational analysis of needs and issues and identification of critical components and strategies, 4) model development, 5) model implementation, and 6) evaluation of the impact of stroke prevention. The study was conducted from March 2019 – February 2021. The qualitative data were analyzed using Stringer’s method, whereas the quantitative data were analyzed using descriptive statistics and t-test. The findings of this study revealed that issues regarding stroke prevention for risk people in the tertiary hospital included struggling to modify eating behaviors, inability to do regular exercise, lack of adequate knowledge about stroke prevention, lack of awareness as being caregivers, constraints of being caregivers, receiving unrealistic treatment regimens, and discontinuing of care. The critical components of the model were: 1) dietary modification relevant to local context, 2) health literacy for stroke prevention, 3) involvement of family caregivers, 4) clinical risk assessment and management, 5) continuity of care among a multi-disciplinary team, and 6) application of technology-based self-care. Strategies used in developing and implementing the model were raising awareness and mutual understanding, strengthening the ability, and promoting collaboration among healthcare providers. Implementation of this model would result in improved eating behaviors regarding stroke prevention, and decreased BMI, sBP, dBP, cholesterol levels, and FBS among stroke risk people, as well as improving knowledge about stroke prevention and readiness in caring among family caregivers. The research findings suggest that collaboration and participation among stakeholders are crucial for development of a stroke prevention model which is appropriate for the setting. Collaboration and participation not only create a sense of ownership but also increase the capability among stakeholders for problem identification and solving.