Acute Stroke, Transient Ischemic Attack
Conditions
Brief summary
Motivational interviewing (MI) is a style of communication designed to elicit a person's own reasons for change to drive commitment toward a goal. The goal of this study is to assess the effect of trainee-led MI on patients diagnosed with acute stroke or TIA attributable to modifiable risk factors in comparison to conventional post-stroke counseling, based on patient outcomes, and meaning of work and sense of fulfillment for trainees.
Interventions
BEHAVIORALMotivational Interview
The motivational interview (MI) is a 10-15 minute patient-centered conversation which will focus on tobacco use. Multiple communication strategies can be employed during the MI, including open-ended questions, affirmative statements, reflective listening, use of a 'confidence ruler', and summarizing. The 'confidence ruler' technique in this patient population involves asking the patient On a scale of zero to ten, how confident are you that you can stop using tobacco?, and then requesting further information about why they selected a certain number. These communication strategies and techniques are designed to uncover and foster a patient's own internal motivations to change the target behavior.
Sponsors
Accreditation Council for Graduate Medical Education
University of Florida
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Patient presentation consistent with a stroke or TIA * Patient is a current tobacco user and tobacco use contributed to the stroke * Resident enrolled in study assigned to Vascular Neurology service during patient admission.
Exclusion criteria
* Patient unable or unwilling to follow up in the outpatient stroke clinic after discharge * Patient has cognitive impairment or aphasia that would preclude meaningful participation in motivational interview (defined as a score of 0 on the National Institute of Health Stroke Scale \[NIHSS\] questions 1 and 9)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Smoking cessation at 90-day post-discharge follow up | 90 days post-discharge | Yes or no |
| Patient rating of ability to improve their health | 90 days post-discharge | Patient answers question I am confident that I can work together with my care team to improve my health with a rating from 1 (do not agree at all) to 10 (completely agree) |
| Recurrence of stroke / TIA symptoms | 90 days post-discharge | Yes or no |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient ability to take stroke prevention medications as prescribed | 90 days post-discharge | Yes or no |
Countries
United States
Outcome results
None listed