TY - JOUR
T1 - Transitioning to home and beyond following stroke
T2 - a prospective cohort study of outcomes and needs
AU - O’Callaghan, Geraldine
AU - Fahy, Martin
AU - O’Meara, Sigrid
AU - Chawke, Mairead
AU - Waldron, Eithne
AU - Corry, Marie
AU - Gallagher, Sinead
AU - Coyne, Catriona
AU - Lynch, Julie
AU - Kennedy, Emma
AU - Walsh, Thomas
AU - Cronin, Hilary
AU - Hannon, Niamh
AU - Fallon, Clare
AU - Williams, David J.
AU - Langhorne, Peter
AU - Galvin, Rose
AU - Horgan, Frances
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - Community reintegration
KW - Needs assessment
KW - Outcomes assessment
KW - Post-stroke transition hospital-to-home
KW - Rehabilitation intervention
UR - http://www.scopus.com/inward/record.url?scp=85189977148&partnerID=8YFLogxK
U2 - 10.1186/s12913-024-10820-8
DO - 10.1186/s12913-024-10820-8
M3 - Article
AN - SCOPUS:85189977148
SN - 1472-6963
VL - 24
SP - 449
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 449
ER -