Impact of transitional care for discharged elderly stroke patients in China: an application of the Integrated Behavioral Model

Geng, Guiling; He, Wei; Ding, Lei; Klug, David; Xiao, Yao

doi:10.1080/10749357.2019.1647650

Cited by 19 publications

(43 citation statements)

References 38 publications

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“…Studies have showed that stroke patients perceive coming home as an important factor for recovery and that at home they express their needs and play the "leading part." 1,17,18 Because the intensity of home visiting was relatively high in this study, important issues about patients or discrepancies were often settled by discussion among multidisciplinary team members and consultation from specialists. Intervention-combined home visits with telephone calls were more beneficial than only home visits for patients after discharge, as suggested by a study.…”

Section: Discussionmentioning

confidence: 98%

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Effects of an integrated transitional care program for stroke survivors living in a rural community: a randomized controlled trial

2020

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Objective: To evaluate the effect of an integrated transitional care program on health outcomes in stroke survivors based on an original community for healthcare. Design: A pilot randomized controlled trial with blinded assessment. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Setting: A tertiary hospital and participants’ home across Lishui, China. Subjects: A total of 98 people with acute cerebral hemorrhage or cerebral infarction, eight weeks following discharge from our hospital. Interventions: Each participant received stroke unit–based treatment including acute medical treatment, early rehabilitation and health education. Patients in the intervention group received ongoing rehabilitation at home through multidisciplinary team, while patients in the control group received secondary stroke prevention. Main measures: Short-Form Health Survey-36, Modified Barthel Index and Caregiver Strain Index at four and eight weeks, respectively, after discharged. Results: A total of 98 participants were recruited (intervention n = 49, control n = 49). Patients had an average age of 61.4 years (61.4 ± 18.3). Mean values of Physical Components Summary and Mental Components Summary, integral components of Short-Form Health Survey-36, were significantly better in the intervention group at four and eight weeks (40.2 ± 6.3 and 42.9 ± 3.7 for the former; 43.9 ± 2.6 and 46.1 ± 1.8 for the later). The same trend was observed in Modified Barthel Index (87.1 ± 9.2 and 92.5 ± 6.7 at four and eight weeks, respectively). But the significant improvement in Caregiver Strain Index was only observed at four weeks. There were significant differences between groups in these scores. Conclusion: The transitional care program has been proven to be feasible and improve health-related outcomes.

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Section: Discussionmentioning

confidence: 98%

“…Major problems associated with hospital-to-home care for adults with stroke include fragmented care and poor communication between patients and healthcare providers. 1 Optimal models of care are urgently needed to mitigate the risk of adverse outcomes resulting from poor care transitions in this population.…”

Section: Introductionmentioning

confidence: 99%

Effects of an integrated transitional care program for stroke survivors living in a rural community: a randomized controlled trial

2020

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“…‘Coming home’ is important for stroke survivors in order to re‐establish self‐esteem and it increases responsibility and understanding of the illness and its consequences in relation to the stroke survivors’ situation (Nordin et al., 2015 ). Discharge from inpatient care might represent major challenges for stroke survivors who face long‐term functional impairments, new medications, rehabilitation goals, fragmented care and poor communication with healthcare providers (Geng et al., 2019 ; Nordin et al., 2015 ). There is considerable amount of literature concerning unmet needs of home‐dwelling stroke survivors (Lin et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…The majority of stroke survivors and their families willingly take responsibility for the recovery at home and generally felt safe and capable to do this (Geng et al., 2019 ). However, homebound stroke survivors receive limited supervised and unsupervised exercise and often have little motivation and confidence towards exercise (Krishnan et al., 2017 ; Mayo, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Stroke survivors’ experiences with rebuilding life in the community and exercising at home: A qualitative study

et al. 2021

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Stroke is a leading cause of serious, long-term disability globally (WHO, 2015a(WHO, , 2015b. Over 50 million stroke survivors experience a wide range of physical, cognitive, emotional and/or psychological problems (Miller et al. 2010;Yoo et al., 2020). Around 74% of stroke survivors require assistance or are dependent on caregivers for daily activities (Miller et al., 2010). The most frequent long-term problems of stroke survivors were limitations in mobility, fatigue, concentration problems and falls (Elf et al., 2016;Saunders et al., 2014).Stroke survivors report a wide range of needs which included: (i) cognitive, psychological and physical function needs; (ii) activity and participatory needs; and (iii) environmental needs, like support, safety and accessibility (Krishnan et al., 2017). There is, however, a growing evidence that multiple long-term needs remain unmet post-

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“…At present, SUs in China are distributed in both tertiary (high-level) and primary care hospitals [16]. Further, nursing professionals have begun to carry out transitional nursing practice for stroke survivors following their discharge from hospital [17,18], which aims to provide patients with holistic care [19].…”

Section: Introductionmentioning

confidence: 99%

Perceived challenges in delivering comprehensive care for patients following stroke: a qualitative study of stroke care providers in Guangdong Province, China

Zou

Chen

et al. 2020

Disability and Rehabilitation

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To understand the challenges in delivering comprehensive care for patients recovering from stroke.Methods: A qualitative study was conducted in two tertiary hospitals with different socio-economic characteristics in Guangdong Province, Southern China.Interviews were conducted with 16 stroke care providers including doctors, nurses, rehabilitation therapists and care workers. The interviews were audiotaped, transcribed and translated from Mandarin Chinese to English.Thematic analysis was used to draw out descriptive and analytical themes relating to care providers' experiences of existing routine stroke care services and the perceptions of challenges in delivering comprehensive stroke care.Results: The interviews with stroke care providers highlighted three key themes that hinder the capacity of the two hospitals to deliver comprehensive stroke care.First, expertise and knowledge regarding stroke and stroke care is lacking among both providers and patients; second, stroke care systems are not fully integrated, with inadequate coordination of the stroke team and inconsistency in care following discharge of stroke patients; third, stroke patients have insufficient social support. Conclusion:While comprehensive stroke care has become a priority in China, our study highlights some important gaps in the current provision of stroke care.

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Impact of transitional care for discharged elderly stroke patients in China: an application of the Integrated Behavioral Model

Cited by 19 publications

References 38 publications

Effects of an integrated transitional care program for stroke survivors living in a rural community: a randomized controlled trial

Effects of an integrated transitional care program for stroke survivors living in a rural community: a randomized controlled trial

Stroke survivors’ experiences with rebuilding life in the community and exercising at home: A qualitative study

Perceived challenges in delivering comprehensive care for patients following stroke: a qualitative study of stroke care providers in Guangdong Province, China

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