Clinical trial NCT06280599: Transitional Care Model for Patients With Stroke
Official title: An Experimental Study of the Application of Transitional Care Model on Patients With Stroke
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Stroke
Lead sponsor: Kaohsiung Medical University
Sponsor class: OTHER
First posted: 2024-02-28
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The patients were divided into two groups: intervention (n=40) and contrast (n=40). Both groups received post-stroke usual care. The intervention group received an 8-week transitional care model for stroke patients, which included comprehensive discharge planning and home follow-up
Primary purpose: SUPPORTIVE_CARE

Brief summary: Patients with stroke benefitted from superior improvements in physical function, particularly when performing activities of daily living, fewer visits to the emergency room, less depression symptoms, and improved health-related quality of life thanks to transitional model care. Despite widespread implementation of transitional care for stroke patients, intervention effectiveness remains inconclusive, and another concern with transitional care for patients is the scarcity of effects on specific findings.

Detailed description: A stroke may be a profound and life-changing occurrence for both the survivors and those who care for them, mandating participation in the adaptation and reinvention of a new post-stroke lifestyle that is sometimes unpredictable and temperamental. The sudden onset of a stroke and its accompanying treatment in an acute hospital setting can be distressing for both patients and caregivers. Admission after stroke may have a profound impact as patients and their caregiver start to understand the effects of the occurrence, which is scary, puzzling, and stressful. Nonetheless, adjusting to situations or life after a stroke might be made easier by implementing relevant and timely strategies throughout hospitalization, discharge, and the post-discharge period. Both populations, stroke patients and caregivers, may have unmet needs once the patients are discharged at home, such as communication, recovery plan and process, medicine, emotional needs, and stroke information, as well as social involvement. To address unmet needs after discharge from the hospital to a variety of settings, such transitional care is recommended to tackle the adverse outcomes.One of the widely used transitional care models is TCM, which was developed at the University of Pennsylvania under the direction of a nurse and was then made available to patients who were elderly at risk of poor outcomes and suffering from chronic illnesses including stroke patients. Incorporated into the model, TCM were developed to meet the needs that arose during hospitalization and to provide continuity of care for patients, including those with stroke, who were unable to receive it after their acute illness treatment

Eligibility criteria: Inclusion Criteria:

* Being at least 18 years old, being admitted in neurology department for at least 24 to 48 hours,
* Not having cognitive impairment as measured by the Montreal cognitive assessment (score ≥ 23),
* Being able to communicate in Indonesia, having the ability to provide informed consent,
* Being willing to participate in this study during hospitalization and 8 weeks after hospital discharge

Exclusion Criteria:

* Have potentially biased information, such as being unable to provide informed consent due to cognitive impairment,
* Having major speech and language problems or aphasia that prevent them from participating in the study,
* Having serious psychiatric disorders or other with terminal disease requiring active treatment, and
* Being discharged to a nursing home or welfare institution.

Primary outcomes:
measure: Self-efficacy
timeFrame: Baseline, at week 4 intervention, and immediately post-intervention at week 8
measure: Activities of daily living
timeFrame: Baseline, at week 4 intervention, and immediately post-intervention at week 8
Secondary outcomes:
measure: Instrumental activities of daily living
timeFrame: Baseline, at week 4 intervention, and immediately post-intervention at week 8
measure: Depression symptoms
timeFrame: Baseline, at week 4 intervention, and immediately post-intervention at week 8
measure: Quality of life in stroke patients
timeFrame: Baseline, at week 4 intervention, and immediately post-intervention at week 8
Other outcomes:
Locations:
city: Kupang
country: Indonesia
facility: RSUD Prof. Dr. W Z Johannes Kupang
Study officials:
affiliation: Kaohsiung Medical University
name: Bih-O Lee, Professor
role: STUDY_CHAIR
References: