title: Therapeutic patient education for stroke survivors: Non-pharmacological management. A literature review.
abstract: OBJECTIVE
  Focus on the different therapeutic patient education (TPE) programs for stroke survivors found in the literature. Verify their content and efficacy.
  
  
  METHODS
  A literature review was conducted by searching for entries from 1966 to 2011 in the Medline and Cochrane Library databases. The references for the accepted articles were taken into consideration and the articles corresponding to the criteria inclusion but not present within the initial search were selected. The keywords used were "self care", "self management", "patient education" and "stroke". Given the multiplicity of symptoms that may be addressed in TPE programs, and following expert advice, the symptoms were grouped after expanding the bibliographic search using the following, additional keywords: "dysphagia"; "swallowing disorder"; "urinary incontinence"; "caregiver"; "fall prevention"; "falling"; "injury"; "shoulder pain"; "physical activity"; "exercise"; "aphasia" and "cognitive impairment".
  
  
  RESULTS
  We found 30 article abstracts. In the end, we only accepted seven articles on general TPE programs that were well structured and detailed enough. The TPE programs found in the literature were often of questionable methodological quality. The multiplicity of symptoms led to very general TPE programs that covered all possible stroke after-effects. The purpose of these programs was to reduce stress and anxiety, to improve quality of life and to alleviate psychosocial after-effects. A change in caregiver and patient behavior was observed at times. We expanded the bibliographic search to include scientific arguments that could help implement TPE programs for more specific targets.
  
  
  CONCLUSIONS
  TPE programs for stroke survivors could be improved by standardizing and assessing programs that focus on a specific problem caused by the various possible after-effects of strokes. In order to promote education for stroke survivors, specific training for health care professionals and appropriate funding are necessary.
authors.affiliation: Service de médecine physique et de réadaptation, laboratoire HAVAE, pôle neuro-sciences tête et cou, université de Limoges, hôpital J.-Rebeyrol, CHU de Limoges, avenue du Buisson, 87042 Limoges, France. jean-christophe.daviet@chu-limoges.fr
authors.forename: J-C
authors.initials: JC
authors.lastname: Daviet
authors.forename: I
authors.initials: I
authors.lastname: Bonan
authors.forename: J M
authors.initials: JM
authors.lastname: Caire
authors.forename: F
authors.initials: F
authors.lastname: Colle
authors.forename: L
authors.initials: L
authors.lastname: Damamme
authors.forename: J
authors.initials: J
authors.lastname: Froger
authors.forename: C
authors.initials: C
authors.lastname: Leblond
authors.forename: A
authors.initials: A
authors.lastname: Leger
authors.forename: F
authors.initials: F
authors.lastname: Muller
authors.forename: O
authors.initials: O
authors.lastname: Simon
authors.forename: M
authors.initials: M
authors.lastname: Thiebaut
authors.forename: A
authors.initials: A
authors.lastname: Yelnik
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D001007:Anxiety / Q000517:prevention & control; D001037:Aphasia / Q000209:etiology / Q000628:therapy; D017028:Caregivers / Q000193:education*; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy; D009043:Motor Activity; D055805:Moving and Lifting Patients; D010353:Patient Education as Topic; D011788:Quality of Life; D013315:Stress, Psychological / Q000517:prevention & control; D020521:Stroke / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy