Using a Structured, Patient-Centred, Educational Exchange to Facilitate a Shared Conversation About Stroke Prevention Medications
JA Coombes, D Rowett, JA Whitty & NW Cottrell
Objective: The aim of this study was to investigate the feasibility of a structured patient-centred educational exchange to facilitate a shared conversation about stroke prevention medications.
Methods: Participants (18 years or older) with a principal diagnosis of stroke or transient ischaemic attack were purposively sampled from the stroke unit of a 780-bed teaching hospital in Australia and consented to participate in the study. A patient-centred educational exchange was conducted face to face at the bedside before discharge and by telephone post discharge. The structure of these sessions was adapted from academic detailing, an educational strategy, which includes identifying experience, listening to the needs of the audience, and tailoring messages to influence behaviour. To facilitate sharing of needs, three questionnaires, validated as research tools, were used to identify participants' experience, perceptions, and beliefs. The identified perceptions were used to personalize educational messages. The outcomes of the study were to provide descriptions of patients' perceptions necessities and concerns about their condition and medications, provide examples of personalized responses to these, evaluate acceptability by patients, and determine the time taken to share the information.
Results: Sixteen participants completed both the bedside session (average duration 27 minutes) and the telephone follow-up (average duration 23 minutes). The strongest patient concern identified was having another stroke. Personalized responses included emphasizing long-term treatment in response to the perception that stroke will last for a short time, reinforcement of necessity for medications, and further exploration of concerns.
Conclusion: The questionnaires engaged the participants, allowing them to share perceptions and beliefs, facilitating a patient-centred educational exchange in a timely manner.