Effectiveness of a stepped self-care program for stroke survivors: A quasi-experimental study

This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care, self-efficacy, and quality of life of stroke survivors.

This quasi-experimental study allocated 110 stroke survivors from two neurology wards into an intervention group (n = 55) who received the stepped self-care program and a control group (n = 55) who received usual care from June to December 2023. The Self-Care of Stroke Inventory, Stroke Self-Efficacy Questionnaire, and the short version of the Stroke Specific Quality of Life Scale were administered at baseline (T₀), immediately post-intervention (T₁), and at 1-month (T₂) and 3-month (T₃) follow-ups. Data were analyzed using repeated measures analyses of variance, and generalized estimating equations.

A total of 48 participants in the intervention group and 50 participants in the control group completed the study. No statistically significant differences were observed at T₀ in any of the measured indicators (all P > 0.05). The study showed significant group, time, and group × time interaction effects across the assessed outcomes (all P < 0.05). Follow-up between-group comparisons at T₁, T_2, and T₃ indicated that the intervention group had significantly higher scores in self-care maintenance, self-care monitoring, self-care management, self-efficacy, and quality of life than the control group (all P < 0.001).

The stepped self-care program significantly improved self-care behaviors, self-efficacy, and quality of life among stroke survivors. These findings support the broader implementation of this approach in post-discharge home self-care.