Feasibility of a Home Hazard Management Program for Malaysian Stroke Survivors
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      This quasi experimental design study aims to examine the feasibility and potential
      effectiveness of a home hazard management program to reduce the rate of falls and fear of
      falling among Malaysian community dwelling stroke survivors. This study will be conducted in
      three local government hospitals in central Malaysia.
    

Detailed description: 
      This study is a pilot quasi experimental study which consists of two groups namely the
      intervention and control group. The experimental group will be implementing the suggested
      home modifications as well as education for functional performance in the homes. In addition,
      this study is a pilot study, therefore the feasibility of the intervention to be implemented
      in practice will be investigated. Other than that, this study also focuses on the outcomes
      from the results in which to analyse the effect of home assessment and modifications on rate
      of falls and fear of falling. The study location is at Hospital Selayang, Hospital UPM and
      Hospital Shah Alam. However, the intervention will be conducted at selected participants
      homes.

      Convenient sampling will be conducted as the sampling method for this study. Any participants
      that fulfil the inclusion criteria will be approach for participation. Information of
      potential participants will be retrieved from the appointment book or online appointment
      system as well as their medical records. The screening and recruitment of participants will
      occur on the same day as their appointment at the hospital by a co-investigator at site.
      Prior to participating, all participants are required to fill up a written consent form. The
      co-investigator at site will approach the participants and explain in detail about the study.
      Information regarding the study, the risk and benefits, confidentiality, withdrawal from the
      study and questionnaires will also be conveyed. Participants will also be informed that they
      will not be paid for their participation, but they will receive a certificate of
      appreciation. Potential participants will be allowed sufficient time to consider their
      participation in the study. Consented participants will be screened using the Modified Rankin
      Scale and the 6-item Cognitive Impairment Test and be invited to take part in the study. The
      participants will be conveniently located into two different groups, namely the intervention
      group and the control group. All participants will be given an appointment for an online
      telehealth session according to the participants appropriate time. The telehealth platform
      that will be used for this study is Coviu-an integrated and specialized telehealth platform
      which is HIPAA-compliant (https://www.coviu.com/). A falls diary will also be given to
      participants by email or mail to record any falls they encountered within 3 months after the
      initial assessment. The participants will then be re-assessed after the 3 months from the
      initial baseline assessments. During the 3 months follow up, the participants are re-assessed
      using the same initial baseline questionnaires. The falls dairy will also be collected via
      email for analysis.

      Recruitment of participants during the initial baseline assessment will stop once it has
      reached 30 participants. However, withdrawal participants will be replaced, until the
      required sample size is achieved. Hospital Selayang and Hospital Pengajar UPM is conveniently
      chosen as the hospital for the intervention group while Hospital Shah Alam is chosen for the
      control group. These hospitals are chosen because of its accessibility for the researchers.
    

Intervention name(s): Home Modification; Education
Intervention type(s): Other; Other
Intervention description(s): Home Modification Intervention
Floor
Provide recommendations to:
Fix the back of the rugs and mats with adhesive/heavy duty tape
Buy non-slip mats
Tie all cables with a proper cable tie
Lighting
Provide recommendations to:
Buy a torch light
To replace worn light bulbs
Buy a light switch
Bathroom
Provide recommendations to:
Buy a non-slip mat
Install a grab rail
Buy a commode chair for showering
Stairways
Provide recommendations to:
• Fix an adhesive tape for stair contrast; Techniques Description Energy Conservation
Take your time
Go to the toilet more often, so you don't have to rush
Use a nearby toilet: commode, different bathroom
Prepare ahead (e.g., toilet paper near, other items for toileting, etc.)
Adjust equipment before changing position
Avoid transfers when tired
Ask for help if you feel sick or especially tired
Allow time for eyes to adjust to change in lighting
Task Simplification
Plan and organise workspaces to eliminate unnecessary steps, save time, energy and reduce fatigue.
Prioritise and plan activities, alternating between active and quiet jobs and include rest periods.
Ergonomics
Proper positioning while doing tasks
Safe mobility around the home
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: A quasi experimental parallel interventional study model in which there will be 2 groups, a treatment group and a controlled group.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: stroke; fall prevention; environmental modification