Effectiveness of Self-Management Education on Behavior Improvement Among Stroke Survivors in Indonesia: A Randomized Controlled Trial

Authors

Yurike Septianingrum, Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, 60237 Surabaya, IndonesiaFollow
Ratna Yunita Sari, 1Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, 60237 Surabaya, Indonesia
Lono Wijayanti, Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, 60237 Surabaya, Indonesia
Rizqa Septiana, Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, 60237 Surabaya, Indonesia
Andis Yuswanto, Stroke Unit, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
Ah Yusuf, Doctor of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
Ika Yuni Widyawati, Doctor of Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
Nor Aziyan Yahaya, Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia

Abstract

Background: This study aimed to investigate the impact of stroke self-management education (SSME) on improving self-management behaviors among stroke survivors.

Methods: An individual randomized controlled trial was conducted from June to August 2024 in an educational hospital in Surabaya, Indonesia. Participants were selected based on the inclusion and exclusion criteria and then randomly assigned via computer-generated randomization to the intervention and control groups. After 3 weeks of intervention, the self-management behavior of stroke survivors was evaluated using the Stroke Self-Management Behavior Questionnaire (SSMBQ). A per-protocol analysis was used to compare the intervention groups, which included only those patients who completed the treatment allocated initially to them. The data was analyzed using descriptive tests, t-tests, and Cohen's d.

Results: Of the 36 participants, 34 completed both baseline and post-intervention assessments (intervention group: 18; control group: 16). All variables were normally distributed and met the assumptions for t-test analysis. The intervention group demonstrated significant improvements in self-integration, self-regulation, interaction with healthcare workers, self-monitoring, and medication adherence (p < 0.001). In contrast, the control group showed a significant change only in self-regulation (p = 0.037). Independent t-tests indicated significant between-group differences across all five indicators (p < 0.001), with large effect sizes (Cohen’s d > 0.65).

Conclusion: The implementation of SSME for 3 weeks effectively improved self-management behaviours. By enhancing knowledge of self-management, stroke survivors will be more motivated to improve their behavior during continued care at home.

Keywords: Non-communicable disease, Patient discharge, Self-management, Social support, Stroke, Indonesia

Recommended Citation

Septianingrum Y, Sari R, Wijayanti L, et al. Effectiveness of Self-Management Education on Behavior Improvement Among Stroke Survivors in Indonesia: A Randomized Controlled Trial. J Health Res. 2025; 39(6):-. DOI: https://doi.org/10.56808/2586-940X.1172

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