Article ; Online: Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs.
2024 Volume 24, Issue 1, Page(s) 449
Abstract: Introduction: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter.: ... ...
| Abstract | Introduction: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter. Methods: A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7-10 days, and at 3-, and 6-months, post-discharge. Results: 72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0-20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were "fair" at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1-9), and three (range:1-7) at 6-months. Conclusion: Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture. Isrctn registration: 02/08/2022; ISRCTN44633579. |
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| MeSH term(s) | Humans ; Female ; Aged ; Male ; Stroke Rehabilitation ; Quality of Life ; Prospective Studies ; Aftercare ; Patient Discharge ; Stroke/therapy ; Stroke/psychology |
| Language | English |
| Publishing date | 2024-04-10 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2050434-2 |
| ISSN | 1472-6963 ; 1472-6963 |
| ISSN (online) | 1472-6963 |
| ISSN | 1472-6963 |
| DOI | 10.1186/s12913-024-10820-8 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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