Effect of a stroke-specific follow-up care model on the quality of life of stroke patients and caregivers: A controlled trial

Abstract

The intervention was not effective in improving quality of life, but was effective in improving levels of social activities. The intervention may have focussed too much on screening for stroke-related problems and not as much on adequate follow-up care and referral.

Update on the State of the Evidence for Stroke Family Caregiver and Dyad Interventions

“…9,10,13,14,17,18 One large study used cluster randomization by unit. 11 The remaining three studies were quasi-experimental (e.g., non-random assignment to condition 12,16 or single group 15 ).…”

“…19 Small pilot studies are useful in testing feasibility of recruitment, retention, and implementation of the intervention, among other procedures; however, intervention effectiveness cannot be adequately determined in these studies. 19 Four studies 9,13,16,18 had moderate sample sizes ranging N=119 16 to N=254, 9 and one study was quite large (N=928). 11 …”

“…18 The rest included all types of informal caregivers, such as family and or friends. Recruitment setting and stage of recovery ranged from inpatient/acute/early discharge 9–12,16 to those who had used “adult daycare services” for at least 12 months. 15 One study included caregivers of survivors who were between six months and 5 years post stroke.…”

A Research Program on Implementing Integrated Care for Older Adults with Complex Health Needs (iCOACH): An International Collaboration

“…The CCM is based on six essential elements that are fundamental to effective partnerships between informed, activated patients and prepared, proactive practice teams: 1) community resources and policies; 2) health care organization; 3) self-management support; 4) delivery system design; 5) decision support; and 6) clinical information systems. However, the focus of chronic care management is often centred on the management of single diseases for individuals rather than on the provision of population-based, comprehensive and integrated health and social care services for people with multiple conditions and their families [11011121314]. In this study we use the CCM to understand and characterize the delivery of ICBPHC.…”

The need to “carer proof” healthcare decisions

“…A recent study of stroke follow-up care unexpectedly showed that the intervention reduced carer depression but did not affect patient outcomes. 6 Conversely, a trial of reminiscence therapy for dementia concluded that though quality of life may have improved for people with dementia who attended the sessions, carers' anxiety increased significantly. 7 Other interventions, such as the closure of mental health beds or the promotion of activity among frail older people, could also benefit patients at the expense of carers.…”