Educational technologies for health education on stroke: an integrative review

integrative review, whose eligibility criteria of the articles were: match the keywords “health education” and “stroke”; be a research paper; be in Portuguese, English and Spanish; be available electronically in the databases LILACS, PubMed/Medline, Scopus and CINAHL; year of publication between 2000 and 2016.

Results:

24 publications were found. The analysis was carried out by means of analytical and interpretive readings. There were many educational technologies used in the health education process for stroke.

Final considerations:

the printed material for general public stood out, aiming to the recognition of alert signs of the disease and the emergency decision-making before suspicious cases of the disease.

Descriptors:
Stroke; Education in Health; Educational Technology; Nursing; Care

Nº	Authors/year	Objective of the Study	Educational technology	Target audience
1	Ishigami, et al (2016)⁽¹²12 Ishigami A, Yokota C, Nishimura K, Ohyama S, Tomari S, Hino TH, et al. Delivering knowledge of stroke to parents through their children using a manga for stroke education in elementary school. J Stroke Cerebrovasc Dis [Internet]. 2016[cited 2016 Dec 04];16(Suppl.l):S234-241. Available from: http://www.strokejournal.org/article/S1052-3057(16)30393-7/pdf http://www.strokejournal.org/article/S10... ⁾	To evaluate the effectiveness of educational materials developed for children of elementary school in conveying information about stroke.	Lecture, video and comics	General population
2	Chan, et al (2015)⁽¹³13 Chan YY, Richardson LD, Nagurka R, Hao K, Zaets SB, Brimacombe MB, et al. Stroke education in an emergency department waiting room: a comparison of methods. Health Promot Perspect [Internet]. 2015[cited 2016 Nov 23];5(1):34-41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430696/pdf/hpp-5-34.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	To evaluate the effectiveness of methods in health education on stroke.	Video, manual and lecture	General population
3	Sakamoto, et al (2014)⁽¹⁴14 Sakamoto Y, Yokota C, Miyashita F, Amano T, Shigehatake Y, Oyama S, et al. Effects of stroke education using an animated cartoon and a manga on elementary school children. J Stroke [Internet]. 2014[cited 2016 Nov 23];23(7):p.1877-81. Available from: https://www.strokejournal.org/article/S1052-3057%2814%2900102-5/abstract https://www.strokejournal.org/article/S1... ⁾	To evaluate the effectiveness educational materials in health education on stroke, for children.	Comics	General population
4	Miyamatsu N, et al. (2012)⁽¹⁵15 Miyamatsu N, Kimura K, Okamura T, Iguchi Y, Nakayama H, Toyota A, et al. Effects of public education by television on knowledge of early stroke symptoms among a Japanese population aged 40 to 74 years: a controlled study. Stroke [Internet]. 2012[cited 2016 Nov 23];43(2):545-9. Available from: https://pdfs.semanticscholar.org/72ec/964cb778c522c1336041db74ca05e49fc3dd.pdf https://pdfs.semanticscholar.org/72ec/96... ⁾	To evaluate the knowledge of the symptoms of stroke from televised education campaign.	Televised media	General population
5	Brown DL, et al (2012)⁽¹⁶16 Brown DL, Conley KM, Resnicow K, Murphy J, Sánchez BN, Cowdery JE, et al. Stroke Health and Risk Education (SHARE): design, methods, and theoretical basis. Contemp Clin Trial[Internet]. 2012[cited 2016 Nov 12];33:721-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361513 https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	To evaluate the effectiveness of an educational intervention in church to reduce risk factors of stroke.	Video, manual and lecture	General population
6	Santos AMB, Oliveira TP, Piemonte MEP (2012)⁽¹⁷17 Barsante SAM, Paula OT, Pimentel PME. Elaboração de um manual ilustrado de exercícios domiciliares para pacientes com hemiparesia secundária ao acidente vascular encefálico (AVE). Fisioter Pesqui [Internet]. 2012[cited 2016 Nov 12];19(1):02-07. Available from: http://dx.doi.org/10.1590/S1809-29502012000100002. http://dx.doi.org/10.1590/S1809-29502012... ⁾	To draw up and apply a manual of home exercises for stroke patients.	Manual	Patients with stroke
7	Williams O, et al. (2012)⁽¹⁸18 Williams O, Desorbo A, Noble J, Gerin W. Child-mediated stroke communication: findings from Hip Hop Stroke. Stroke[Internet]. 2012[cited 2016 Dec 21];43:163-9. Available from: http://stroke.ahajournals.org/content/43/1/163?ijkey=2ecea3a79ac195a96529c16f608e74e61b927ccf&keytype2=tf_ipsecsha http://stroke.ahajournals.org/content/43... ⁾	To evaluate the impact of a musical intervention and of other technologies in heath education about stroke, for children.	Music (Hip Hop), cartoons, electronic games, comics, lecture.	General population
8	Cruz TV, et al. (2012)⁽¹⁹19 Cruz VT, Araújo I, Alves I, Magano A, Coutinho P. Freeze the stroke: public awareness program for immediate detection of first symptoms. Stroke[Internet]. 2012[cited 2016 Dec 15];43:S2510-2512. Available from: http://stroke.ahajournals.org/content/43/9/2510.short http://stroke.ahajournals.org/content/43... ⁾	To evaluate the impact of an educational intervention for early identification of symptoms of stoke.	Lecture and posters	Patients with stroke
9	Goldfinger JZ, et al (2012)⁽²⁰20 Goldfinger JZ, Kronish IM, Fei K, Graciani A, Rosenfeld P, Lorig K, et al. Peer education for secondary stroke prevention in inner-city minorities: design and methods of the prevent recurrence of all inner-city strokes through education randomized controlled trial. Contemp Clin Trials [Internet]. 2012[cited 2016 Nov 24];33:1065-73. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22710563 https://www.ncbi.nlm.nih.gov/pubmed/2271... ⁾	To evaluate educational intervention in patients with stoke for controlling the modifiable risk factors.	Lecture	Patients with stroke
10	Williams, O, et al. (2012)⁽²¹21 Williams O, Desorbo A, Noble J, Shaffer MG, Gerin W. Long-Term learning of stroke knowledge among children in a high-risk community. Neurol[Internet]. 2012[cited 2016 Nov 12];79:802-6. Available from: http://dx.doi.org/10.1212/WNL.0b013e3182661f08 http://dx.doi.org/10.1212/WNL.0b013e3182... ⁾	To evaluate the impact of an educational program on parents of children applied for an intervention of orientation about stroke.	Music (Hip Hop), cartoons, electronic games, comics	General population
11	Williams O, et al (2014)⁽²²22 Williams O, Hecht MF, DeSorbo AL, Huq S, Noble JM. Effect of a novel video game on stroke knowledge of 9 to 10-year-old, low-income children. Stroke[Internet]. 2014[cited 2016 Nov 12]45(3):S889-892. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24481976 https://www.ncbi.nlm.nih.gov/pubmed/2448... ⁾	To evaluate educational intervention based on an electronic game for improving the knowledge in children about stoke.	Electronic games	General population
12	Álvarez, et al (2011)⁽²³23 Álvarez E, Gallegos S, Romero E, Moraga C, Estadella C, Viviani V. Impact of early intervention for stroke caregivers: a pilot study. Rev Chil Ter Ocup[Internet]. 2011[cited 2016 Dec 10];11(2):23-33. Available from: http://www.revistaterapiaocupacional.uchile.cl/index.php/RTO/article/viewFile/17776/18557 http://www.revistaterapiaocupacional.uch... ⁾	To evaluate the effectiveness of an educational intervention for caregivers of stroke patients after hospital discharge.	Lecture and flyers	Caregivers
13	Holzemer EM, et al (2011)⁽²⁴24 Holzemer EM, Thanavaro J, Malmstrom TK, Cruz-Flores S. Modifying risk factors after TIA and stroke: the impact of intensive education. J Nurse Pract[Internet]. 2011[cited 2016 Sep 12];7(5):372-7. Available from: http://www.npjournal.org/article/S1555-4155(11)00036-5 http://www.npjournal.org/article/S1555-4... ⁾	To evaluate educational plans for controlling the risk factors and lifestyle changing in post-stroke patients.	Flyers and telephone advice	Patients with stroke or TIA
14	Davis SM, et al (2009)⁽²⁵25 Davis SM, Martinelli D, Braxton B, Kutrovac K, Crocco T. The impact of the extended parallel process model on stroke awareness: pilot results from a novel study. Stroke [Internet]. 2009[cited 2016 Dec 13];40(12):3857-63. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19797185 https://www.ncbi.nlm.nih.gov/pubmed/1979... ⁾	To evaluate messages about stroke and long-term message retention.	Poster	General population
15	Müller-Nordhorn, et al (2009)⁽²⁶26 Müller-Nordhorn J, Wegscheider K, Nolte CH. Population-based intervention to reduce prehospital delays in patients with cerebrovascular events. Arch Intern Med [Internet]. 2009[cited 2016 Nov 10];169: 1484-90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19752406 https://www.ncbi.nlm.nih.gov/pubmed/1975... ⁾	To reduce delays in the search for emergency care through population-based educational intervention.	Flyers	General population
16	Bell M, et al (2009)⁽²⁷27 Bell M, Lommel T, Fischer JG, Lee JS, Reddy S, Johnson MA. Improved recognition of heart attack and stroke symptoms after a community-based intervention for older adults, Georgia, 2006-2007. Prev Chronic Dis[Internet]. 2009[cited 2016 Dec 12];6(2):41. Available from: http://www.cdc.gov/pcd/issues/2009/apr/08_0101.htm http://www.cdc.gov/pcd/issues/2009/apr/0... ⁾	To evaluate educational intervention in elderly for improving knowledge about acute myocardial infarction and stroke.	Lecture	General population
17	Kleindorfer D, et al (2008)⁽²⁸28 Kleindorfer D, Miller R, Sailor-Smith S, Moomaw CJ, Khoury J, Frankel M. The challenges of community-based research: the beauty shop stroke education project. Stroke [Internet]. 2008[cited 2016 Dec 12];39(8):2331-35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18566304 https://www.ncbi.nlm.nih.gov/pubmed/1856... ⁾	To develop and evaluate educational intervention for black women in beauty salons.	Manual and flyers	General population
18	Skidmore ER, et al (2008)⁽²⁹29 Skidmore ER, Koeing KL, Whyte EM, O´Donnell L, Penrod L, Lenze EJ. Do clinical rehabilitation education programs really improve stroke-related knowledge? Am J Phys Med Rehabil [Internet] 2008 [cited 2016 Nov 20];87(8):637-41. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18401264 https://www.ncbi.nlm.nih.gov/pubmed/1840... ⁾	To evaluate the impact of an educational program about stroke in a rehabilitation clinic.	Lecture and flyers	Patients with stroke
19	Wall HW, et al (2008)⁽³⁰30 Wall HK, Beagan BM, O’Neill J, Foell KM, Boddie-Willis CL. Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST campaign. Prev Chronic Dis [Internet]. 2008[cited 2016 Nov 20];5(2):a49. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18341784 https://www.ncbi.nlm.nih.gov/pubmed/1834... ⁾	To evaluate educational program for improving the knowledge about stoke among women between 40-64 years.	Video and flyers	General population
20	Green T, et al (2007)⁽³¹31 Green T, Haley E, Eliasziw M, Hoyte K. Education in stroke prevention: Efficacy of an educational counselling intervention to increase knowledge in stroke survivors. Canadian J Neuroscience Nurs[Internet]. 2007[cited 2016 Nov 23];29(2):13-20. Available from: http://www.cann.ca/~ASSETS/DOCUMENT/ARTICLES/CJNN-29-2-2007-green.pdf http://www.cann.ca/~ASSETS/DOCUMENT/ARTI... ⁾	To evaluate the impact of individual patient-nurse interview on acquiring knowledge about stroke.	Manual	Patients with stroke
21	Villarroel, et al (2007)⁽³²32 Villarroel EV, Fonseca IM, Diaz XR, Eberhard AA. Implementación de un taller educativo para familiares de personas con accidente cerebro vascular. Rev Chilena Ter Ocup[Internet]. 2007[cited 2016 Dec 12];7:1-13. Available from: http://200.89.78.45/index.php/RTO/article/viewFile/83/63 http://200.89.78.45/index.php/RTO/articl... ⁾	To report the experience of an educational lecture for caregivers of patients with stroke.	Lecture	Caregivers
22	Handschu R, et al (2006)⁽³³33 Handschu R, Reitmayer M, Raschick M, Erguth F, Neundorfer B, Babjar E. First aid in acute stroke. J Neurol[Internet]. 2006[cited 2016 Nov 13];253(10):1342-46. Available from: http://link.springer.com/article/10.1007/s00415-006-0219-7 http://link.springer.com/article/10.1007... ⁾	To evaluate the knowledge about stroke and the risk factors after an educational lecture.	Lecture	General population
23	Jiang B, et al (2004)⁽³⁴34 Jiang B, Wang WZ. Effects of urban community intervention on 3-year survival and recurrence after first-ever stroke. Stroke[Internet]. 2004[cited 2016 Dec 12];35(6):1242-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15118176 https://www.ncbi.nlm.nih.gov/pubmed/1511... ⁾	To evaluate the impact of an educational intervention in the post-stroke survival and the recurrence of the disease.	Lecture, manual and flyers	General population
24	Nassif KR, et al (2002)⁽³⁵35 Nassif RK, Swartz R, Reardon M. Implementing a community education program on stroke for health care providers and consumers. Educ Health[Internet]. 2002[cited 2016 Dec 12];15(1):59-64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14741988 https://www.ncbi.nlm.nih.gov/pubmed/1474... ⁾	To evaluate the use of teleconference between health professionals.	Conference Call	Health professionals

Educational technology	n	%
Educational technology type
Printed materials	17	70.8
Educational lecture	15	62.5
Electronic Materials	10	41.6
Music	2	8.3
Television	1	4.2
Phone call	1	4.2
Target audience of the educational process
General population	14	58.3
Patients	6	25.0
Caregivers	3	12.5
Health professionals	1	4.2
Total of studies	24

Themes	n	%
Definition of stroke/ Organ affected in stroke	17	70.8
Identification of signal and symptoms of stroke	14	58.4
Modifiable risk factors for stroke	12	50.0
Attitude before a stroke	12	50.0
Preventive measures for stroke	10	41.7
Acute ischemic stroke treatment	6	25.0
Basic activities of daily living (ADL)	4	16.7
Total of studies	24

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[1] CORRESPONDING AUTHOR: Samia Jardelle Costa de Freitas Maniva E-mail: samia.jardelle@gmail.com