Effects of a 4-week transitional care programme for discharged stroke survivors in Hong Kong: a randomised controlled trial.

摘要: Stroke rehabilitation involves care issues concerning the physical, psychosocial and spiritual aspects. Hospital-based has its limitations because many of only emerge when patients return home. Transitional models supporting after discharge from hospital have proved to be effective among chronically ill patients, but limited studies were conducted stroke survivors. This study was a randomised controlled trial test effectiveness transitional programme (TCP) which nurse-led 4-week designed based on assessment-intervention-evaluation Omaha System framework. Between August 2010 October 2011, 108 who discharged home, able communicate, had slight moderate neurological deficits disability into control (n = 54) intervention groups 54). Data patient-related clinical outcomes collected at baseline, 4 weeks TCP completed 8 hospital. Repeated measures analysis variance with intention-to-treat strategy used examine outcomes. There significant between-group differences in quality life, primary outcome measure this study, both physical (F(1, 104) 10.15, P 0.002) mental 8.41, 0.005) domains, domain achieved time × interaction effect 103) 7.73, 0.006). The group better spiritual-religion-personal measures, higher satisfaction, Modified Barthel Index scores lower depression compared group. They also readmission use emergency room rates, difference control. is original testing model shares common features that been applied duration seems adequate bring about immediate effects.