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  • Title: Effects of a transitional home-based care program for stroke survivors in Harbin, China: a randomized controlled trial.
    Author: Kam Yuet Wong F, Wang SL, Ng SSM, Lee PH, Wong AKC, Li H, Wang W, Wu L, Zhang Y, Shi Y.
    Journal: Age Ageing; 2022 Feb 02; 51(2):. PubMed ID: 35180283.
    Abstract:
    BACKGROUND: China has the biggest stroke burden in the world. Continued measures have been taken to enhance post-stroke rehabilitation management in the last two decades. The weak link is with home-based rehabilitation, with more attention and resources devoted to inpatient rehabilitation. OBJECTIVE: to address the service gap, this study tested a home-based transitional care model for stroke survivors. METHODS: a randomized controlled trial was conducted from February 2019 to May 2020 in Harbin, China, involving 116 patients with ischemic stroke. The intervention group participants (n = 58, 50%) received a 12-week home-based care program with components of transitional care measures and the national guidelines for facilitating patients to perform home-based exercises with continued monitoring and gradual progression. Control group participants received standard care including medication advice, rehabilitation exercise and one nurse-initiated follow-up call. Data were collected at baseline and after a 90-day (post-intervention) and a 180-day (post-intervention) follow-up. The primary outcome was quality of life (QOL), measured using the EuroQol-Five Dimension 5-Level scale (EQ-5D-5L). RESULTS: both intervention and control groups showed improvement in EQ-5D-5L from baseline to post-intervention (0.66 versus 0.83, P < 0.001) and (0.66 versus 0.77, P < 0.001), respectively, and there was significant group-by-time interaction in EuroQol-Visual Analogue Scale from baseline to post-intervention at 90 days and follow-up at 180 days with the intervention group experiencing better improvement. Similarly, significant interaction effects were also found in the Stroke Impact Symptom scale, self-efficacy and modified Barthel Index. CONCLUSIONS: home-based transitional care was effective in improving QOL, symptoms, self-efficacy and activities of daily living.
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