Table 1.

Relative merits and suitability of different methods for getting information to patients with stroke

Methods of information delivery	Strengths	Weaknesses	Suitability
Giving information verbally  By health professionals  By patients with stroke	Professional consultation or advice is essential in effective health information provision for stroke patients[30] Health professionals are considered by patients as a good and knowledgeable source of information[25] Patients prefer and strongly desire the one-on-one verbal discussion with health professionals[31,32,33] Patients can receive the tailored and detailed information when their individual needs or concerns are taken into consideration[31,33] Patients can receive personalized support and practical help when their individual needs or concerns are taken into consideration[31,33] Through face to face communication between patients in group learning or local stroke support groups, stroke patients can share their stories with each other and hear about their experiences at first hand. In particular, the “expert patient” can provide the valuable information about effective coping strategies for managing their everyday lives poststroke[34]	Verbal information given by health professionals may be very expensive and time-consuming due to the fact that it happens in person and on an individual basis[36] It is easy for patients to forget the verbally delivered information[45] Health professional-related barriers which may hinder stroke patients’ getting information include lack of knowledge, lack of time, or poor communication skills[46]	The suitability may be limited to stroke patients without cognitive impairments It is not suitable for stroke patients who have problems with speaking or language, understanding, memory, and concentration[30]
Printed materials  Patient information leaflets or booklets  Magazines or newspapers  Medical books or professional journals	It mainly provides written information or explanations and is viewed by patients as a valuable resource[31] Receiving information in written form is very helpful, especially for patients to use for reference when required during the future recovery process[23] Information in printed materials can be consistent and help recall[35] Medical books or professional journals have a higher level of accuracy and reliability than written information in other formats[36]	It mainly presents general and uniform information but cannot provide the targeted information to meet each patient's individual needs and to best fit his or her particular situation[47] The acceptability and readability of the information may not have been ensured and examined[17] Their level of readability, especially that of medical books or professional journals, can be too high, and therefore the information can be considered as nonunderstandable, unacceptable and unsuitable for patients[48] Patients may misunderstand the content written in professional books or journals, and so develop false interpretations or expectations about their own disease or treatment[49] The accessibility of academic publications is questionable[36] The accuracy and reliability of the information from magazines or newspapers are questionable[36] Patients’ disease condition may have been changed since they are given the information, so they may no longer consider the information to be useful and helpful[50] The written information may be in danger of getting out of date quickly so that it is important to ensure that it includes current information consistent with present and the latest state of the art evidence in the field of stroke care[51]	Patient information leaflets or booklets, and magazines or newspapers are useful mainly for patients who have the ability to read and understand It is unfeasible for patients to get written information if they have cognitive impairments, such as problems with concentration, perception, and understanding, as well as age-related vision loss.[30] It is important that the materials are in an appropriate format with large text, suitable colors, and shorter and “easy to read” language[61,62] Medical books or professional journals are more suitable for health professionals to seek information than for patients with stroke[36]
Audio/visual materials	They have the wider acceptability by stroke patients than other information delivery methods no matter whether or not patients can read	The content and quality of information delivered in audio/visual format have not been sufficiently evaluated[17]	Audio/visual information is particularly beneficial for stroke patients who are not able to read and is similarly suitable for patients who have the ability to read
	Stroke patients can easily listen to or watch the recorded audio/visual materials at their own speed and convenience[37] The information presented in visual materials, such as television programs, is usually very vivid[36] The information presented in visual materials, such as television programs can easily peak the interests and curiosities of the audience[36] The television program is considered as the favorite information resource by stroke patients[38] The use of videos may help explain the information[23] The use of videos may help facilitate understanding, for example, it is easy for patients to understand complicated anatomical knowledge through watching three-dimensional images[23]
Electronic information	Maintaining active participation  Patients with stroke can search information by themselves[28]  Providing support through on-line discussion and self-help groups can facilitate patients’ participation in decision-making and healthcare[39,40] Presenting information in different ways  The Internet can present various types of information, such as texts, audios, or videos, to meet the particular needs of stroke patients who prefer the information to be given in different format[18] Relative ease of access  The Internet is a convenient and beneficial information resource[32] Anybody who has a computer connected to the Internet and some technical skills can seek information on the web[41]  Anybody who has a computer connected to the Internet and some technical skills can share information on the web[41] Meeting individual patient's specific learning needs  Patients are allowed the opportunity to access information on their own pace[42]  Patients are allowed the opportunity to access information at their preferred time[42]  Patients are allowed the opportunity to access information at their preferred place[42]  Patients are allowed the opportunity to access information when they are actually ready to learn[42] Getting first-hand information from expert patients  The use of Internet has the potential for peer information giving, sharing and co-learning from and with each other, through electronic forums or other forms of group, community and peer learning activities or programs[43]  The Internet and video-conferencing communication in particular can help novice patients get expert patients’ first-hand information about coping strategies, and empower them to self-manage their chronic long-standing disease, as highlighted by the government policies[44]	The lack of accuracy and reliability  The content, accuracy, and reliability of information posted on the Internet have not been sufficiently evaluated[23]  The inaccurate and misleading information may be spread through the Internet due to the lack of quality control and restrictions on online information publication[32,52]  It is usually more difficult for lay people to make an accurate judgment on the quality of Internet information[32,52] The inappropriate readability level  The level of readability of some stroke information websites is unsuitably higher than patients’ level of understanding[53,54] The incorrect or even dangerous information  Health information is not scrutinized or peer-reviewed before being presented on the website,[55] so incorrect and potentially dangerous information can be found on websites[56] The barriers to computer access and the use of Internet  Patients with disability, poor financial condition or low education level often encounter barriers to computer access and the use of Internet[57,58]  The difficulties of accessing electronic information encountered by the vulnerable group of older patients aged 75 years and above also deserve careful consideration by information providers to reduce their higher risk of social exclusion[59,60] The problems with ease of navigation, currency of information, design and esthetics, organization and presentation of information[54]  Patients are easy to get lost, confused or overwhelmed, or to receive misleading or out-dated information[55]	Using Internet to provide information can particular cater patients’ needs after discharge when they are difficult to access other resources[30] It may not be an ideal information source for stroke patients with disabilities, such as aphasia, in which patients often have particular problems with cognitive processing of information, memory, attention and understanding[54] It is not suitable for patients without access to computer[54] It is not suitable for patients without access to Internet[54] It is not suitable for patients without any previous experiences of using Internet[54]