Programme d'éducation thérapeutique à la prévention des chutes après un AVC: illustration d'une pratique clinique
Résumé
Objective To identify the feasibility of a therapeutic education program to prevent falls after a stroke during inpatient rehabilitation. Methods The present program is built according to the methodological guidelines proposed by the SOFMER. It has been validated by the ARS. Inclusion criteria Post-stroke inpatients and their family caregivers. The program includes individual activities for learning tasks and group activities for the exchange of coping strategies. Patients, as well as the learning process, are then assessed. Results Fifty-three inpatients admitted in our rehabilitation hospital were included in the program during the period between 1st June 2011 and 30th December 2012. Last stroke occurrence ranged from 14 days to 12 months (mean, 2.8 months) for 41 patients. Twelve patients had a chronic hemiplegia. All had histories of falling. At the end of the program, 42 patients (85%) acquired theoretical and practical skills determined by the educational diagnosis. Nine patients reported falls between 4 and 6 months after the end of the program. A traumatic injury after fall was described in one patient. Conclusion Evaluations of multifactorial interventions likes TPE, with cognitive impaired stroke survivors, were particularly difficult to perform. TPE justifies larger programs to further assess efficacy and cost effectiveness.