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A process evaluation of a stroke-specific follow-up care model for stroke patients and caregivers; a longitudinal study.

Fens M, Beusmans G, Limburg M, van Hoef L, van Haastregt J, Metsemakers J, van Heugten C - BMC Nurs (2015)

Bottom Line: There were 1074 problems identified and the SCCs initiated 363 follow-up care and referral options.The intervention was only partially performed in accordance with the protocol and was positively evaluated by patients, caregivers and SCCs.It is recommended to add a structured referral system to the intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Patient & Care, Maastricht University Medical Centre+, Maastricht, The Netherlands ; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.

ABSTRACT

Background: There is a need for follow-up care after stroke, but there is no consensus about the way to organise it. An intervention providing follow-up care for stroke patients and caregivers showed favourable effects on the level of social activities, but no other effects were found. The intervention consists of a maximum of five home visits to patients and caregivers during a period of 18 months post-discharge. The home visits are conducted by a stroke care coordinator (SCC) using a structured assessment tool. The objective of this study was to examine process-related factors that could have influenced the effectiveness of the intervention.

Methods: 77 stroke patients, 59 caregivers and 4 SCCs participated in the study. Data on the organisational characteristics of and the satisfaction with the intervention were collected by means of structured assessments, interviews and self-administered questionnaires at 1, 6, 12 and 18 months of follow-up. The intervention was provided between April 2008 and June 2011.

Results: Patients received an average of 3.8 home visits (SD 1.4) and 55% of them had a follow-up period of a maximum of 18 months. There were 1074 problems identified and the SCCs initiated 363 follow-up care and referral options. Stroke patients and caregivers were very satisfied with the intervention. The SCCs were satisfied with the assessment tool, but would like to see a structured referral system.

Conclusions: The intervention was only partially performed in accordance with the protocol and was positively evaluated by patients, caregivers and SCCs. It is recommended to add a structured referral system to the intervention.

No MeSH data available.


Related in: MedlinePlus

Flow chart of (A) the referral of stroke patients to home care services and (B) the inclusion process.
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Fig1: Flow chart of (A) the referral of stroke patients to home care services and (B) the inclusion process.

Mentions: The first part of the process-evaluation focused on the discharge destination of stroke patients after hospitalisation or inpatient rehabilitation. FigureĀ 1-part A shows that out of a total of 620 stroke patients, who were admitted to the stroke unit of the hospital during the inclusion period, 347 patients were discharged home, 241 of them being referred to home care services (69% of the total number of stroke patients). In addition, there were 26 patients who were referred to the home care services by other health care professionals, such as physiotherapists, GPs and nurse practitioners, who were left out of consideration for the evaluation about the availability of the intervention. The total of 267 patients that were referred to the home care services were offered the intervention, which was implemented as regular care in the Maastricht area at the beginning of the study period.Figure 1


A process evaluation of a stroke-specific follow-up care model for stroke patients and caregivers; a longitudinal study.

Fens M, Beusmans G, Limburg M, van Hoef L, van Haastregt J, Metsemakers J, van Heugten C - BMC Nurs (2015)

Flow chart of (A) the referral of stroke patients to home care services and (B) the inclusion process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307745&req=5

Fig1: Flow chart of (A) the referral of stroke patients to home care services and (B) the inclusion process.
Mentions: The first part of the process-evaluation focused on the discharge destination of stroke patients after hospitalisation or inpatient rehabilitation. FigureĀ 1-part A shows that out of a total of 620 stroke patients, who were admitted to the stroke unit of the hospital during the inclusion period, 347 patients were discharged home, 241 of them being referred to home care services (69% of the total number of stroke patients). In addition, there were 26 patients who were referred to the home care services by other health care professionals, such as physiotherapists, GPs and nurse practitioners, who were left out of consideration for the evaluation about the availability of the intervention. The total of 267 patients that were referred to the home care services were offered the intervention, which was implemented as regular care in the Maastricht area at the beginning of the study period.Figure 1

Bottom Line: There were 1074 problems identified and the SCCs initiated 363 follow-up care and referral options.The intervention was only partially performed in accordance with the protocol and was positively evaluated by patients, caregivers and SCCs.It is recommended to add a structured referral system to the intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Patient & Care, Maastricht University Medical Centre+, Maastricht, The Netherlands ; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.

ABSTRACT

Background: There is a need for follow-up care after stroke, but there is no consensus about the way to organise it. An intervention providing follow-up care for stroke patients and caregivers showed favourable effects on the level of social activities, but no other effects were found. The intervention consists of a maximum of five home visits to patients and caregivers during a period of 18 months post-discharge. The home visits are conducted by a stroke care coordinator (SCC) using a structured assessment tool. The objective of this study was to examine process-related factors that could have influenced the effectiveness of the intervention.

Methods: 77 stroke patients, 59 caregivers and 4 SCCs participated in the study. Data on the organisational characteristics of and the satisfaction with the intervention were collected by means of structured assessments, interviews and self-administered questionnaires at 1, 6, 12 and 18 months of follow-up. The intervention was provided between April 2008 and June 2011.

Results: Patients received an average of 3.8 home visits (SD 1.4) and 55% of them had a follow-up period of a maximum of 18 months. There were 1074 problems identified and the SCCs initiated 363 follow-up care and referral options. Stroke patients and caregivers were very satisfied with the intervention. The SCCs were satisfied with the assessment tool, but would like to see a structured referral system.

Conclusions: The intervention was only partially performed in accordance with the protocol and was positively evaluated by patients, caregivers and SCCs. It is recommended to add a structured referral system to the intervention.

No MeSH data available.


Related in: MedlinePlus