Primary aim of the study is to investigate if motivational interviewing can be an effective way to motivate en stimulate patients with recent TIA or ischemic stroke to change their lifestyle and maintain this healthy lifestyle. Moreover we will…
ID
Source
Brief title
Condition
- Other condition
- Vascular hypertensive disorders
Synonym
Health condition
neurovasculaire aandoeningen
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary outcome measures will be lifestyle behavior change, defined as smoking
cessation and/ or increase of physical activity of 30 minutes and increase of 5
points at the Food Frequency Questionnaire after 6 months.
Secondary outcome
Secundary outcome measures will be motivation to change liefstyle,
applicability and feasibility of motivational interviewing on our nurse led
out-patient prevention clinic and change in weigth, waist, blood pressure,
cholesterol and blood glucose at 6 months.
Background summary
Patients with Transient Ischemic Attack (TIA) or ischemic stroke carry an
increased risk of recurrent stroke of 6% each year. Stroke recurrence is a
consistent and independent prognostic factor of disability,
institutionalization and death. Much higher is the risk of other vascular
conditions after stroke or TIA, this can raise to 50%. Hence, secondary
prevention is an important part of stroke care.
Pharmacological en surgical interventions lower the risk of recurrent stroke
and other cardiovascular conditions. Little is known about the contribution of
lifestyle behavior changes at this risk reduction. Epidemiological studies
showed unhealthy lifestyle, like physical inactivity, smoking, overweight and
unhealthy diet can increase the risk on stroke and other vascular conditions.
Healthy lifestyle can influence vascular risk factors positively, for instance,
modest weight loss in the obese can improve hypertension and hyperglycemia.
Moreover, in patients with coronary artery disease the benefits of lifestyle
management on vascular risk factors as well as the incidence of vascular death
and myocardial infarction have been clearly demonstrated. Therefore, lifestyle
management can be an effective way to reduce stroke recurrence.
Over 400 patients with TIA or ischemic stroke visit our nurse-led secondary
prevention clinic each year. Informing and advising patients about healthy
lifestyle is an important part of stroke care. Changing lifestyle is difficult
and can be hampered by the cognitive and functional impairment and old age of
our population. Motivation is essential to change lifestyle and maintaining
this change. We are investigating other determinants witch can influence
intention and motivation to change at this moment in a prospective cohort
study.
Motivational interviewing can be an effective way to help patients with TIA or
ischemic stroke to change their unhealthy lifestyle. Earlier research and meta-
analysis showed positive effects of motivational interviewing on changing
unhealthy lifestyle at patients with chronic conditions and patients with
cardiovascular conditions. Motivational interviewing appears a useful method to
change health behavior by nurses. This method is particully effective in short
(15 minutes) conversations and more than one encounter with the patient ensures
the effectiveness of motivational interviewing.
Little is known about the effects of motivational interviewing on lifestyle
behavior change in patients with TIA or ischemic stroke. Hopeful effects on
physical activity, diet, blood pressure, self-efficacy and compliance where
showed in two small studies. However the duration of the conversations and the
intensity of the intervention aren*t reported.
In this study we will investigate if motivational interviewing can motivate en
stimulate patients with recent TIA or ischemic stroke to change their lifestyle
and maintain this healthy lifestyle. Moreover we will investigate applicability
and feasibility of this intervention on our nurse led out-patient prevention
clinic.
Study objective
Primary aim of the study is to investigate if motivational interviewing can be
an effective way to motivate en stimulate patients with recent TIA or ischemic
stroke to change their lifestyle and maintain this healthy lifestyle. Moreover
we will investigate applicability and feasibility of this intervention on our
nurse led out-patient prevention clinic.
Study design
Randomized controlled trial with blinded outcome assessment
Intervention
One nurse specialist will follow a motivational interviewing training of 4
days. This specialist will patients of the interventiongroep. Patients who
receive the intervention will have 3 extra visits of 15 minutes, 1 month, 2
months and three months after discharge following the principles of
motivational interviewing. Patients in the controlegroup will only have
standard conversations being admitted to the stroke unit or visiting the
outpatient clinic. During this conversations lifestyle will be discussed, but
no advise or motivational technics will be applied. This patients will visit
the outpatient clinic after 4 weeks en 3 months after discharge. The will be
done bij the untrained nurse specialist.
Study burden and risks
Their are no risks of participation. Patients in the interventiongroup can
experience some benefits.
Patients will be assesed during regular visits. Patients in the
interventiongroup will have one extra visit.
Molewaterplein 40
Rotterdam 3000 CA
NL
Molewaterplein 40
Rotterdam 3000 CA
NL
Listed location countries
Age
Inclusion criteria
Patients will be eligible for inclusion if they are 18 year or older, and have a clinical diagnosis of TIA or ischemic stroke
Exclusion criteria
Patients will be excluded if they are discharged to a nursing home, are non-Dutch speaking or notably aphasic.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL39881.078.12 |