Nurse-Led Tele-Education Improves Self-Efficacy and Reduces Stroke Readmissions: A Quasi-Experimental Study

Stroke is a leading cause of long-term disability worldwide. Low self-efficacy and high hospital readmission rates remain major barriers to successful post-stroke rehabilitation. Nurse-led tele-education has emerged as a potential strategy to support continuity of care after hospital discharge.

To examine the impact of a structured nurse-led tele-education and follow-up program on self-efficacy and hospital readmission among stroke survivors.

This quasi-experimental pretest-posttest study with a control group was conducted between April 2023 and August 2024 among stroke patients discharged from two tertiary hospitals in Hamadan, Iran. Eligible participants were allocated to intervention (n = 127) and control (n = 127) groups using a simple random number table. Eligible participants were allocated to intervention (n = 127) and control (n = 127) groups using a simple random number table. Because blinding was not feasible, the study was conducted using a quasi-experimental design. The intervention group received a 2-week tele-education program delivered via a mobile messaging application, complemented by weekly nurse-led follow-up calls, while the control group received usual discharge care with monthly follow-up contacts. Self-efficacy was assessed at baseline and 6 weeks after discharge using the Persian version of the Stroke Self-Efficacy Questionnaire. Hospital readmission was monitored over a 6-month follow-up period.

Participants (mean age: 65.32 ± 7.25 years) showed no baseline self-efficacy differences. Post-intervention, the intervention group had significantly higher self-efficacy scores (p < 0.001) and lower 6-month readmission rates (9.6% vs. 21.2%, OR = 2.51, p < 0.05).

Early, structured tele-nursing was associated with higher self-efficacy and lower hospital readmission rates among stroke survivors. This model appears feasible, scalable, and potentially cost-effective for post-stroke care.