Abstract
OBJECTIVES: 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. METHODS: 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 (T(0)), immediately post-intervention (T(1)), and at 1-month (T(2)) and 3-month (T(3)) follow-ups. Data were analyzed using repeated measures analyses of variance, and generalized estimating equations. RESULTS: 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 T(0) 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 T(1), T(2,) and T(3) 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). CONCLUSIONS: 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.