AsianScientist (Apr. 29, 2025) – The Singapore Stroke Registry reported 9,702 episodes of stroke in 2022, a 52.4 percent jump from the figures reported in 2012. At the same time, the age-standardized mortality rate dropped from 18.5 to 14.2 per 100,000 patients. So, while stroke remains a prevalent concern, patients are increasingly more likely to survive a stroke.
For many stroke survivors, the journey to recovery is tough. Weakened mobility, difficulties with speech and motor skills, and even poor memory retention are among the possible complications survivors face post-stroke. Recovery is also different for each survivor—some can recover in a matter of days, while others might require stroke rehabilitation for years to come. One key challenge that hinders recovery is the patient’s lack of knowledge of post-stroke management.
“Patient education is not always a primary concern in busy tertiary hospitals. Many patients and their informal caregivers aren’t always clear about their condition and how they should manage it at home,” said Elaine Siow, an Associate Professor in the Health & Social Sciences cluster at Singapore Institute of Technology (SIT).
Recognizing this care gap, Associate Professor Siow wanted to improve how information and materials are delivered to stroke patients. Currently, patient education in community hospitals is delivered through booklets and pamphlets. Associate Professor Siow was interested in finding out whether the use of gamified learning can help improve patients’ knowledge and confidence in caring for themselves.
In collaboration with the stroke care team at Ang Mo Kio-Thye Hua Kwan Hospital, Singapore, Associate Professor Siow led a research group to develop a smartphone app that provides fundamental post-stroke education and self-care measures to patients and their caregivers. The app features learning resources, daily mood check-ins and helpful games to improve patients’ cognitive skills and medicine adherence.
What makes the app truly unique lies in how it was designed.
“We used a co-design approach which involved patients, caregivers, clinicians, occupational therapists, physiotherapists and the app vendor in the initial app development stage. Each party provided ideas as to what the app should contain and how it should be designed. We then let them try the prototype of the app and gathered their feedback again,” explained Associate Professor Siow, who carried out the research in two phases after the prototype was developed.
In the first phase, the research team conducted qualitative discovery interviews with stroke patients and caregivers. The purpose of this phase was to determine the participants’ perceived needs and evaluate their experience using the app. The second phase was a pilot study to assess the app’s feasibility in a community hospital setting.
Overall, Associate Professor Siow received positive feedback on the app from both stroke survivors and informal caregivers who participated in her research. For some of the participants, she observed improved scores in self-efficacy and self-management in terms of knowledge about post-stroke care after they used the app. Additionally, she gained deeper insights into the different needs of this community.
“We found that stroke survivors and caregivers seek different types of information. Stroke survivors tend to prefer topics related to their health and well-being, while caregivers look for resources and services in the community as well as self-help skills to cope with their caregiving role,” she said. “Stroke survivors also feel the need to maintain strong bonds with their loved ones, who often end up as their caregivers.”
Associate Professor Siow is optimistic about the potential impact of her research and hopes to secure funding to continue refining the app before making it available for public use. She is also keen to create app content in different languages, tailor the content to patients in various recovery stages and expand the app’s use case to patients with other health concerns, such as chronic kidney disease.
“Ultimately, my hope is that patients and caregivers will use this app as part of the recovery journey. The app could complement existing care practices and help patients cope with recovery at home, once they are discharged from the hospital,” expressed Associate Professor Siow, who is currently spearheading another research project that looks at technology adoption in community hospitals.
An orthopedic nurse by training, she is no stranger to patient care and how hospitals work. Where stroke patients are concerned, she believes that nurses play a big role in helping the patients manage their condition and motivating them to take charge of their own recovery—but with how busy hospitals can get, this role becomes secondary. This prompts Associate Professor Siow to pursue research in electronic health (eHealth) and create patient-centric, technology-driven solutions.
“Technology, gamification and artificial intelligence are gaining popularity in healthcare. There are many ways to try and use technology to complement the way we work as well as improve it, particularly in lean workforces like nursing. The way I see it, technology plays a complementary role to nurses in helping patients recover,” she concluded.
For more information on the eHealth intervention app for post-stroke care, contact Associate Professor Elaine Siow here.
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Source: SIT; Freepik
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.