Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers

Yang, Li; Zhao, Qi; Zhu, Xuemei; Shen, Xiaoying; Zhu, Yulan; Liu, Yang; Gao, Wei; Li, Minghui

doi:10.1007/s11136-017-1550-4

Cited by 16 publications

(8 citation statements)

References 31 publications

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“…Second, education level had a signi cant negative impact on URBMI inpatients. Sinceeducation level was considered an important factor causing prehospital delay in stroke treatment,better educated UEBMI patients sought stroke treatment earlier,with reduced ALOS, than URBMI patients [46]. This is consistent with Milagros et al [47]who reported that low levels of education hada strong relationship with longer length of hospitalstays.Our results also revealed that GDP per capita was signi cantly associated with hospital costs and OOP.Economic factors are universally acknowledged as a main factor affecting healthcare utilization.…”

Section: Discussionsupporting

confidence: 86%

Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China

Yang

Nicholas²,

Maitland

et al. 2020

Preprint

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Background: Stroke is a devastating disease that imposes a heavy financial burden on patients and their families and a significant economic cost on a nation’s healthcare system. Under China’s fragmented health insurance system, it was unclear whether geographic variations in healthcare utilization and hospital expenditures lead to healthcare inequities for stroke inpatients. This study assesses the geographic variations in stroke patients’ healthcare utilization and hospital expenses and the potential geographical influencing factors. Methods: Covering all municipalities and provinces in mainland China, our main data were a 5% random sample of stroke claims from the Urban Employees Basic Medical Insurance (UEBMI) and Urban Residents Basic Medical Insurance (URBMI) schemes from 2013 to 2016, totaling 217969 inpatients and 280804 admissions. The Theil index was employed to evaluate the (in)equity in healthcare utilization and hospital expenditures across all 31 mainland Chinese provinces. Using multiple linear regression analysis, the geographic influencing factors, comprising ability to deliver healthcare, geographical accessibility of health services, healthcare-seeking and economic factors, were explored.Results: UEBMI stroke inpatients had higher hospital costs and longer ALOS, but lower OOP expenses than those with URBMI. UEBMI insurance had a lower Theil index value than the URBMI scheme. Stroke patients’ healthcare utilization and hospital expenditures showed significant differences both within and between regions. The intra-region Theil (in)equality index value was higher than the inter-region Theil index, with the Theil index highest within eastern China, China’s richest and most developed region. The ability to deliver healthcare, the enabling factors and the provincial-level economic factors had significant effects (P<0.05) on healthcare utilization and hospital expenses.Conclusions: Our data revealed significant geographic variation in healthcare utilization and hospital expenditures for stroke patients. In addition to differences in the coverage and reimbursements of the UEBMI-URBMI schemes, disparities within regions were associated with the ability to deliver healthcare (open hospital beds per 100 patients), the enabling factors (regional reimbursement rate and regional education level) and the provincial-level economic factors (GDP per capita). China’s fragmented urban health insurance schemes require further reform to ensure better equity in healthcare utilization and hospital expenses.

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Section: Discussionsupporting

confidence: 86%

Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China

Yang

Nicholas²,

Maitland

et al. 2020

Preprint

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“…Low level of education results in the low level of disease-related knowledge and ability to acquire knowledge, and thus adversely affect the care ability of the caregivers to a certain extent, [ 27 ] causing anxiety, depression and other adverse emotional reactions to the caregivers. This suggests that health care workers should focus on women, self-financed, and long-term caregivers in future clinical work, and perform effective individualized interventions, such as psychological counseling, technical training and education, [ 28 ] to reduce the emergence and development of anxiety and depression of the caregivers.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients

et al. 2018

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To investigate the anxiety/depression of caregivers of stroke patients.This study used a cross-sectional survey design and convenience sampling.Totally, 117 caregivers of stroke patients were enrolled. Data were collected from questionnaires. Hamilton anxiety scale, Hamilton depression scale, and Zarit caregiver burden interview were performed. Multiple linear regression and correlation analysis were used.The anxiety score, depression score and total burden score of 117 stroke caregivers were 16.56 ± 8.02, 18.63 ± 9.39, and 25.88 ± 10.35, respectively. Anxiety symptoms, mild to moderate depressive symptoms, and severe depressive symptoms were found in 43.9%, 26.5%, and 27.4% of the caregivers, respectively. Daily care time and medical payment method were influencing factors for anxiety and depression (P < .05). Both anxiety and depression were positively correlated with total care burden score (P < .01).Anxiety and depression are common in the caregivers of stroke patients and are closely related to care burdens. In this regard, appropriate home care guidance, psychological counseling and social support should be provided to the caregivers to reduce their physical and mental burden.

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“…They had knowledge and skills to accept the condition of stroke survivors after discharge; thus, their caregiver preparedness was better. However, caregivers without caregiving experience often lacked knowledge of stroke, which affected their ability to judge and handle emergency situations (Moon, 2017; Yang et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Effects of personal characteristics, disease uncertainty and knowledge on family caregivers' preparedness of stroke survivors: a cross‐sectional study

Liu

Huang

et al. 2020

Nursing & Health Sciences

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Family caregivers play an important role in the rehabilitation of stroke survivors. The aims of this study were to describe preparedness, uncertainty, and knowledge regarding stroke in family caregivers of people who have undergone strokes and to investigate factors influencing preparedness. A total of 306 caregivers completed the questionnaires, including the Caregiver Preparedness Scale, the Mishel Uncertainty in Illness Scale, and Knowledge of Stroke. The result showed that the mean score of the family caregivers' preparedness was 14.42, the mean score of disease uncertainty was 75.62, and the mean score of stroke knowledge was 10.41. Caregiver preparedness was negatively correlated with disease uncertainty and positively correlated with knowledge. Multivariate stepwise regression analysis showed that educational background, profession, caregiving experience and uncertainty degree of the family caregivers, gender, and age of stroke survivor could predict 45.90% of the total variation in preparedness. The findings suggest that demographic characteristics of stroke survivor and family caregiver, as well as caregivers' disease uncertainty, enable predict the level of caregiver preparedness. Medical professionals should pay attention to providing personalized and targeted approaches to maximize caregivers' preparedness.

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Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers

Abstract: The comprehensive educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.

Cited by 16 publications

References 31 publications

Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China

Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China

Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients

Effects of personal characteristics, disease uncertainty and knowledge on family caregivers' preparedness of stroke survivors: a cross‐sectional study

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