Self-Determination Theory Application In The Discharge Of Patients With Transient Ischemic Attack

Abstract

Background: The principle of transient ischemic attack treatment is lifestyle modification and pharmacological treatment that would reduce recurrence and incidence of stroke. Lifestyle changes require follow-up care and continuity of nurse and patient relationships, but the current training does not meet this need. The trainings based on motivating theory such as self-determination, besides continuity of the relationship with patient, improve his/her incentive, specially of it is carried out at the discharge time. Therefore, this study has been done by the purpose of defining the impact of discharge plan based on self-determination theory on the lifestyle patients with transient ischemic attack.

Methodology: The analysis has been done on 57, 18-90 years old clinical random patients in Tehran hospitals (29 cases and 28 controls) in 2015. Data were collected by demographic questionnaire at the beginning and health-promoting lifestyle questionnaire(second edition) were collected at the end of the study. Discharge plan based on self-determination theory, including patients and families meeting in hospital and telephone counseling during the 12 weeks after discharge was accomplished in cases group. The control group received only routine hospital care. Data were analyzed by t-test and chi- squre test.

Results: The score of lifestyle was similar in both groups (p> .05) at beginning of the study, but at the end of the study, the average score of cases group (17.1 ± 164.2) significantly higher than the control group (17.6 ± 118.3) (p < 0.001). Furthermore, At the end of study, the mean scores of nutrition, physical activity, stress management, interpersonal relationships, spiritual growth and responsibility in the lifestyle cases group was significantly higher than the control group (p <.001). The frequency of transient ischemic attacks after discharge in the cases group (13.8%), significantly lower than the control group (46.4%), respectively (p = .016).

Conclusion: By executing discharge plan based on self-determination theory, transient ischemic attack patients lifestyle score increased to 26.7% and the frequency of transient ischemic attacks32.6% reduces. So use this simple and accessible program in the care of patients with ischemic attack is recommended.