Evaluation of a Stroke Family Support Organiser

Abstract

Background and Purpose-There is inconclusive evidence of the effectiveness of the Stroke Family Support Organiser (FSO) service. We report the results from a randomized controlled trial of the service. Methods-Stroke patients admitted to hospital and their informal caregivers were randomly allocated to receive the FSO service (nϭ126) or standard care (nϭ124). Outcome assessments were undertaken 4 and 9 months after recruitment with the General Health Questionnaire 12, Carer Strain Index, Barthel Index, Extended Activities of Daily Living scale, and a specially designed questionnaire to determine knowledge of stroke and satisfaction with services. Results-There were no significant differences between groups in patients' mood and independence in personal or instrumental activities of daily living or caregivers' mood, strain, or independence. Patients in the intervention group were significantly more knowledgeable about whom to contact for stroke information, reducing the risk of stroke, practical help, community services, and emotional support. Patients in the intervention group were also significantly more satisfied with the stroke information received. Caregivers in the intervention group were significantly more knowledgeable about whom to contact for information on stroke, reducing the risk of stroke, community services, and emotional support. Caregivers in the intervention group were also significantly more satisfied with stroke information. Conclusions-The FSO service had no significant effect on mood, independence in activities of daily living, or reduction in caregiver strain, but it did increase knowledge of stroke and satisfaction with that knowledge. The results may not be representative of all FSO services, and the sample was small relative to the heterogeneity of the participants. However, results suggest that the policies and training procedures of FSOs need to be evaluated to ensure that a cost-effective service is being provided to stroke patients and their caregivers.

Is Stroke Early Supported Discharge still effective in practice? A prospective comparative study

“…A satisfaction questionnaire (4 point likert scale) was used to assess perceived knowledge and satisfaction with information on stroke. 16 Caregivers were asked to complete the GHQ-28, the SF-36 and the satisfaction questionnaire. The NEADL and carer outcomes were not included at baseline assessment.…”

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

“…512 The involvement of patients more consistently in developing, implementing, and refining their care plan to achieve a mutually established care objective by all interdisciplinary team members is also increasingly being demonstrated to positively affect adherence to lifestyle and medication recommendations. [513][514][515] b. Outpatient and Chronic Care Settings Given the comorbidities of the stroke survivor that contribute in most instances to the initial stroke, it is essential that secondary stroke prevention strategies remain in place within outpatient and chronic care settings. Furthermore, data indicate that approximately 14% of stroke survivors will experience another stroke within 1 year of their primary event.…”

Development and evaluation of tools and an intervention to improve patient- and carer-centred outcomes in Longer-Term Stroke care and exploration of adjustment post stroke: the LoTS care research programme

“…Analysis was therefore conducted on an existing data set, 36 with a similar population to that of the stroke system of care trial, to identify criteria to enable us to distinguish between stroke survivors in terms of their social activity level (based on Barthel Index and FAI scores). In this population the median (interquartile range) reduction in Barthel Index score and FAI score from pre stroke to 12 months post stroke was 4 (1-8) and 16 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) respectively. Three main categories of stroke survivors were defined: 'doing better than expected', 'failing to thrive' and 'doing as expected (doing well)'.…”

“…Introductory text was finalised and advice and guidance on use of the manual were provided. Each reference guide has a (21) number of sections ('The problem', 'The evidence' and 'Addressing the problem') followed by the algorithm. A frequency table was also provided for each of the problem areas (e.g.…”

“…16 Previous service models for post-stroke care have been associated with equivocal, [17][18][19][20][21] and sometimes adverse, outcomes. 20 There was a requirement therefore for innovative models of care to be developed, more closely tailored to the expressed needs of patients and their carers, and embedded in local stroke services.…”