| Summary: | 碩士 === 長榮大學 === 護理學系碩士班 === 99 === A quasi-experimental design was used in this study to examine the effect of "transitional care" on stroke patients and their primary caregivers. The study subjects included 36 dyads of patients and caregivers in the experimental group who received "transitional care" and 34 dyads in the control group who received the standard discharge education. Transitional care included a hospital visit by a patient care manager three days before discharging from the hospital and home visits three days, two weeks, and three weeks after discharging.
Pre-test data of both groups were collected when the patients were ready to be discharged from the neurology ward of a medical center in southern Taiwan. Post-test data were collected at the patients’ homes one month after discharge from the hospital. Patients in the control group were chosen to match age within 5 years and the Barthel Index score with that of experimental subjects. There were no significant differences in the age, gender, education, or self-reported health of the primary caregiver between the two groups. Outcome measures included the Barthel Index, the Care Outcome Scale, the Caregivers Readiness Scale, the Caregivers Need and Satisfaction Assessment Tool, the unplanned readmission rate, and the rate of falling.
With regard to patients, the post-test showed that the Barthel Index score increased more in the experimental group than in the control group (38.75 vs 32.79), but the difference did not reach statistical significance. The experimental group showed a significantly higher total score in the Care Outcome Scale than the control group (t = 3.00, p<0.01). Among the 11 items of the Care Outcome Scale, the scores of 4 items (daily food selection and preparation, care or assistance service resources, use of supportive devices, and medical care arrangements) were significantly higher in the experimental group than in the control group. The fall incidence of the experimental group (0.896%) was lower than that of the control group (2.846%). There were two unplanned hospital readmissions happened in the experimental group while there were none in the control group.
With regard to the caregiver, the Caregiver Readiness Scale score increased in both groups.There was a higher increase in the experimental group (11.25) than in the control group (9.94), but the difference was not significant. Among the 44 items of the Caregiver Need and Satisfaction Assessment Tool, in only 5 items did more than 10 caregivers from each group indicate that they need help. Only one item (joint exercise) had a significantly higher increase in satisfaction in the experimental group than in the control group (t = 2.03, p <0.05).
This study found that transition care helped stroke patients with self-care and function more than the control group although these differences did not reach statistical significance. However, the effect of transitional care on the patient care outcome and caregiver preparedness was significant. The study results can be used to help health care providers assist with home care for stroke patients and caregivers.
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