Methods
Design
The pilot study employed a mixed methods design. A prospective
cohort design was utilized to obtain a convenience sample of
20 consenting adult participants attending an SPCwith hypertension
and confirmedminor stroke or probable transient ischemic
attack and deficits in any or all of cognition,medication self-efficacy
and self-reported medication adherence. Additionally, a
qualitative analysis of NCMvisit notes, client responses to openended
questions and other communications was conducted to
identify recurrent themes or concepts of the NCM experience
from the nurse and client perspectives (Straus & Corbin, 1990).Study setting
The study was conducted in an outpatient SPC located in an
urban, university-affiliated regional stroke centre hospital. Each
designated Ontario Stroke Centre must meet identified best
practice requirements. They are responsible for organizing the
human and medical resources required to provide continuum
of care stroke services across their respective regions (Ontario
Stroke System, 2008). The study site SPCmanages approximately
1,000 client referrals annually (HHS, 2009). Five neurologists,
one CNS, one part-time nurse clinician, and one administrative
support person routinely staff the SPC. A specialist in internal
medicine with an interest in stroke is available for consultation.
Additionally, a dietetic assistant contributes to monthly client
educational sessions, as one component of usual care.