Development of Integrated Discharge-Planning Programme for Stroke Patients
Keywords:
integrated discharge-planning programme, family caregivers, stroke patientsAbstract
Objective: To develop a discharge-planning programme for internal medicine stroke patients, and to assess two aspects of the programme outcomes, namely, the caregivers, in terms of caregiving preparedness, direct care-induced stress, and quality of life, and the patients, in terms of preventable complications and need for re-admission
Design: Research and development
Methodology: This study was conducted between October 2021 and June 2022 in four stages: 1) analysis of discharge-planning situation; 2) development of an integrated discharge-planning programme for stroke patients, based on Naylor’s theory of transitional care; 3) trial of the developed programme on two pairs of patients and caregivers, followed by evaluation of outcomes and adjustment of the programme for increased reliability; and 4) utilisation of the adjusted programme and final outcome assessment.
The research was designed as a two-group quasi-experimental study with a post-test. The participants were 30 pairs of stroke patients and their caregivers selected based on the inclusion criteria and equally assigned to a control group and an experimental group, 15 pairs in each. Whilst the control group received the standard discharge plan, the experimental group participated in the researcher-developed integrated discharge-planning programme.
Data were collected from the caregivers and the patients. The data from the caregivers were collected through a personal information form, the preparedness scale, the direct care-induced stress scale, and the quality of life scale. The data from the patients were collected through a personal information form, the preventable complication scale, and the re-admission records. The data were analysed based on frequency, percentage, mean, chi-square statistics, and T statistics.
Results: The caregivers in the experimental group achieved significantly higher mean scores on caregiving preparedness and pre-discharge quality of life than those in the control group did (p < .05). However, the two groups’ mean score on direct care-induced stress did not differ significantly (p > .05). One month after discharge, the experimental group also achieved significantly higher mean scores on caregiving preparedness and pre-discharge quality of life than the control group did (p < .05), and displayed a significantly lower level of direct care-induced stress than the control group did (p < .05). As for the patients, neither the experimental group nor the control group displayed any complications. Whereas two of the patients in the control group were re-admitted, none of those in the experimental group was.
Recommendations: It is recommended that hospitals have a policy to apply this integrated discharge-planning programme to treating internal medicine stroke patients, to promote their caregivers’ caregiving preparedness and quality of life.
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