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Effects of a 4-week transitional care programme for discharged stroke survivors in Hong Kong
 — a randomised controlled trial
Author(s)Frances Kam Yuet Wong, Siu Yeung
Journal titleHealth and Social Care in the Community, vol 23, no 6, November 2015
PublisherWiley Blackwell, November 2015
Pagespp 619-631
Sourcewileyonlinelibrary.com/journals/hsc
KeywordsStroke ; Discharged patients ; Aftercare ; Evaluation ; Clinical surveys ; Hong Kong.
AnnotationStroke rehabilitation involves care issues concerning the physical, psychosocial and spiritual aspects. Hospital-based rehabilitation has its limitations, because many of the care issues only emerge when patients return home. Transitional care models supporting patients after discharge from the hospital have proved to be effective among chronically ill patients, but limited studies have been conducted with stroke survivors. This study was a randomised controlled trial conducted to test the effectiveness of a transitional care programme (TCP), which was a nurse-led 4-week programme designed based on the assessment-intervention-evaluation Omaha System framework. Between August 2010 and October 2011, 108 stroke patients who were discharged home, able to communicate, and had slight to moderate neurological deficits and disability were randomised into control (n = 54) and intervention groups (n = 54). Data on the patient-related and clinical outcomes were collected at baseline, 4 weeks when the TCP was completed, and 8 weeks after discharge from hospital. Repeated measures analysis of variance with intention-to-treat strategy was used to examine the outcomes. There were significant between-group differences in quality of life, the primary outcome measure of this study, in both physical (F(1, 104) = 10.15, P = 0.002) and mental (F(1, 104) = 8.41, P = 0.005) domains, but only the physical domain achieved a significant time * intervention interaction effect (F(1, 103) = 7.73, P = 0.006). The intervention group had better spiritual-religion-personal measures, higher satisfaction, higher Modified Barthel Index scores and lower depression scores when compared with the control group. They also had lower hospital readmission and use of emergency room rates, but only the use of emergency room had significant difference when compared to control. This study is original in testing a transitional model among stroke patients discharged from hospital. The TCP shares common features that have been proved to be effective when applied to chronically ill patients, and the duration of 4 weeks seems to be adequate to bring about immediate effects. (RH).
Accession NumberCPA-151022214 A
ClassmarkCQA: LFD: LN: 4C: 3G: 7DR

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