BackgroundThe goal of the study was to investigate the long-term course of health-related quality of life (HRQoL) in stroke survivors during and up to 2.5 years after inpatient neurological rehabilitation and to identify predictors of HRQoL.MethodsHRQoL was determined in 152 stroke survivors in a single-centre prospective cohort study at four time points: upon admission to inpatient rehabilitation, at discharge, and one and 2.5 years after discharge. Their HRQoL was determined by administering the EQ-5D at all four measurement points. During inpatient rehabilitation, the SF-36 was administered in addition to the EQ-5D. Predictors were identified through multiple regression analysis.ResultsDuring inpatient rehabilitation, the “European Index” of the EQ-5D rose significantly (p < 0.001) from 45.4 to 66.7. The change in HRQoL on the SF-36 was convergent. The HRQoL of the stroke patients living at home remained at the same level for 2.5 years following discharge. In the multiple regression analysis, the EQ-5D Index at discharge (p = 0.049), the risk of falls as defined by Runge and Rehfeld (p = 0.001), and the change in emotional quality of life on the SF-36 during inpatient rehabilitation (p = 0.048) predicted HRQoL 2.5 years following discharge.ConclusionOn the basis of our results, we conclude that the long-term health-related quality of life of stroke survivors can be positively influenced by reducing the risk of falls and improving emotional well-being during neurological inpatient rehabilitation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0258-9) contains supplementary material, which is available to authorized users.

Within the first four weeks after discharge, the patients in the intervention group had fewer new illnesses. In the observation period the use of outpatient care services was more frequent in the intervention group than in the control group. Conclusion: Even though there are few differences of moderate intensity between the two groups the intensified transition programme does not affect either the functional status of the stroke patients or the health of the carers.

Objective: To investigate an intensified transition concept between neurological inpatient rehabilitation and home care for long-term effects on the care situation two and a half years after stroke patients' discharge. Design: Controlled clinical trial allocating patients to intervention group (intensified transition on ward II) or control group (standard transition on ward I); patients were allocated to whichever ward had a vacancy. The last follow-up assessment was carried out on average 31 months after discharge. Intervention: The intensified transition concept consisted of therapeutic weekend care, bedside teaching and structured information for relatives during the second phase of the rehabilitation. Subjects: Seventy-one patients and their family carers were included, of which one case dropped out. Therefore 70 family carers Á 35 individuals in each group Á were available for assessment at long-term follow-up. Data collection: Family carers were asked via telephone whether the patient was still alive and if so, where he or she is living Á at home or in a nursing home. Statistical methods: Binary logistic regression analysis with the care situation (home care versus institutionalized care or deceased) as dependent variable. Results: Two and a half years after discharge (T3) in the intervention group significantly fewer patients were institutionalized (2 versus 5) or deceased (4 versus 11) (P 0/0.010). Multivariate analysis showed that besides a higher functional life quality at discharge and lower patient's age, the participation in the intensified transition programme is the third significant predictor for home care at T3. Conclusion: Effects of an intensified transition programme can persist over a long-term period. They can sustain home care by reducing institutionalization and mortality.

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Abstract. Because they offer an easy entry into play, casual games have become an increasingly popular leisure activity among children and teenagers, engaging particularly broad target audiences. In this paper, we present a casual game that addresses childhood cancer: Besides mere entertainment, a health game that focuses on cancer may serve as a clinical tool in order to teach children about the particularities of the disease and initiate discussion among cancer patients, their parents and medical staff. In this context, the results of an empirical study revealed a generally high acceptance of the health game among young patients, while parents and medical staff highlighted the educational potential of health games addressing cancer. Additionally, we discuss the challenges of evaluating digital games in a hospital setting which were revealed during the evaluation phase.