Elective Endovascular Program with Point-of-care Platelet Function Test promotes stroke patient satisfaction and better health outcomes: a pilot study.

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Abstract Description
Abstract ID :
HAC6552
Submission Type
Authors (including presenting author) :
RN Mr. Ho Kin Hang.
Affiliation :
DOM Ms. Wu Mei Chun, WM Mr. Cheng Hang Wai, APN Ms Ng Ka Wai, APN Ms. Yung Kam Yee, & RN Mr. Ho Kin Hang.
Introduction :
Endovascular stenting is one of the treatment for difficult aneurysms and intracranial vascular stenosis. Dual antiplatelet therapy with Aspirin and Plavix is required for preventing in-stent thrombosis and atherothrombotic events. The dosage of antiplatelet therapy should be tailored individually according to drug responsiveness and the risk of bleeding and thrombosis should be balanced. Therefore, an Elective Endovascular Stenting (EES) program has been implemented in the Department of Neurosurgery, Kwong Wah Hospital since 2012. It is consisted of two parts: (1) Point-of-care platelet function test for drug adjustment, (2) Patient education for better drug compliance and healthy behaviors by experienced nurses. An evaluation is needed to review the effectiveness of the program.
Objectives :
The objective of this study is to assess the effectiveness of the patient education part in the EES program by examining patients’ motivations for adapting health-related behaviors, their willingness to learn and the knowledge gained.
Methodology :
This was a cross-sectional, descriptive, and mixed methodology study. A convenient sampling was used. Patients joined EES Program with Glasgow Coma Scale 15 were eligible in the study. A 27-item questionnaire was developed based on the 6 domains of Health Belief Model (HBM), i.e. perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy, and Consumer Information Process Model (CIPM). At the time of data collection, from June 2020 to Sept 2020, patients were divided into pre- and post-education group. Descriptive statistic, mean score and frequency were compared among two groups.
Result & Outcome :
22 participants were recruited in this pilot study. For the questions about the 6 domains of HBM, there were no significant differences between the pre- and post-education groups. This could be explained by the following: (1) patient had more motivation to modify their lifestyle once diagnosed, (2) patients could gain knowledge easily through the internet, (3) healthcare professionals provided education throughout the whole hospitalization period even beyond the EES program and (4) the core family culture promoted more cue to action for healthy behaviors, higher self-efficacy and better drug compliance. For questions about the CIPM, more patients were willing to discuss their health condition and learn more from health professionals in post-education group. This implied that EES program could raise their awareness about their health and promote their willingness to learn. The effectiveness of the EES program could be further confirmed by the higher mean score of knowledge assessment in the post-education group. The overall comment of EES program was affirmative. Patients could build their trust to healthcare providers and their confidence to manage their diseases because of the patience and caring of nursing staff. In conclusion,Patient education session in the ESS program could not only improve patients’ knowledge, but also creating a great trust relationship between health professionals and patients, and hence promoting higher patient satisfaction and better health outcomes.

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