A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial

Abstract

Background: Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care. Methods: This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as "participant dyads", and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcome is changes in self-efficacy of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors' and quality of life, functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers' self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline. Discussion: This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers.

Status Quo and Influencing Factors of Discharge Readiness of Patients with Bilateral Ureteral Stoma After Radical Cystectomy

“…Patients living alone are relatively poorly prepared for discharge. Analysis of the reasons shows that because bladder cancer is high in the elderly, most of the spouses are retired, and they can provide life care and companionship for patients, and emergency situations can be dealt with and help in time, and patients have a relatively higher sense of safety when discharged from the hospital ( 18 ). Patients living alone have poor self-care ability, cannot fully grasp the method of ostomy bag replacement and stoma care methods in the short term, encounter emergencies or difficulties in life, cannot get help and support from family members, and the patient’s sense of security is relatively low.…”

Transitions of Care Coordination Intervention Identifies Barriers to Discharge in Hospitalized Stroke Patients

“…Previous literature, including the Transition Coaching for Stroke and Translational Stroke Clinic programs, utilized advanced practice providers to improve stroke prevention and compliance in the outpatient setting (15)(16)(17). By comparison, this study and others sought to improve transitions of care from the acute care hospital setting to other facilities and home, which is in line with the National Quality Forum and Institute of Medicine priorities (18)(19)(20). This TOCC study attempts to facilitate care throughout the duration of the hospitalization of the AIS patient.…”

Nursing Stroke Patients

“…While continued physiotherapy, occupational therapy, speech therapy and psychology if available, will be invaluable for some patients, nurses have a major role to play both in coordinating care and ensuring that a holistic approach is taken as well as providing specialist nursing functions. A trial from China currently underway should provide interesting data on some of these aspects of care [21]. Nurses have a key role in supporting patients in the longer term including supporting self-management [22] and encouraging effective strategies for stroke prevention [23].…”