Gothenburg Very Early Supported Discharge study (GOTVED): a randomised controlled trial investigating anxiety and overall disability in the first year after stroke

Rafsten, Lena; Danielsson, Anna; Nordin, Åsa; Björkdahl, Ann; Lundgren‐Nilsson, Åsa; Larsson, Maria; Sunnerhagen, Katharina S.

doi:10.1186/s12883-019-1503-3

Cited by 16 publications

(43 citation statements)

References 35 publications

(49 reference statements)

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“…This literature review finally examined 20 articles, of which 19 were RCTs and 1 was an RPT. Regarding international location, 85% of the studies were conducted in Europe [Norway ( 10 – 15 ): 6, Denmark ( 16 – 20 ): 5, Netherlands ( 21 ): 1, Sweden ( 22 , 23 ): 2, UK ( 24 , 25 ): 2, Portugal ( 26 ): 1], 10% were conducted in Asia [China ( 27 ): 1, Hong Kong ( 28 ): 1], and 5% were conducted in North America [USA ( 9 ): 1]. For the intervention types, seven studies provided type I intervention, whereas 13 studies provided type II intervention.…”

Section: Resultsmentioning

confidence: 99%

Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis

et al. 2022

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ObjectiveTo investigate the available evidence on early supported discharge (ESD) and transitional care (TC) delivery service in patients with cerebrovascular disease.MethodsA systematic literature search was conducted to collect all available evidence on the use of ESD and TC services. We included cluster-randomized pragmatic trials or randomized controlled trials (RCTs) that recruited patients with stroke or transient ischemic attack to receive either conventional care or any care service intervention that included rehabilitation or support provided by professional medical personnel with the aim of accelerating and supporting home discharge. Relevant data were electronically searched through international databases (Cochrane Library, EMBASE, and PubMed) and incorporated into a summary grid to investigate research outcomes and provide a narrative synthesis. Furthermore, we compared the outcomes in terms of length of hospital stay, patient and caregiver outcomes, and mortality through meta-analysis.ResultsWe identified and included a total of 20 publications of various original randomized studies. There were 18 studies conducted in western countries and 2 in eastern countries. The meta-analysis revealed a tendency that ESD or TC could decrease the length of hospital stay more than the usual care [standardized mean difference (SMD) −0.13; 95% confidence interval (CI) −0.31 to 0.04 days; P = 0.14]. Moreover, there was a tendency that ESD resulted in better activities of daily living (ADL) than usual care (SMD 0.29; 95% CI −0.04 to 0.61; P = 0.08). Patient outcome based on modified Rankin scale (mRS) score (SMD −0.11; 95% CI −0.38 to 0.17; P = 0.45] and mortality (odds ratio 0.80; 95% CI 0.56–1.17; P = 0.25) did not reveal any significant difference. The Caregiver Strain Index revealed no difference.ConclusionWe did not find a large effect size for the use of TC and ESD. When implementing the TC and ESD model from western to Asian countries, services should be prepared and implemented in accordance with national medical rehabilitation pathways for cerebrovascular disease.

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Section: Resultsmentioning

confidence: 99%

Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis

et al. 2022

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“…29 Our higher prevalence of post-stroke anxiety may be attributed to the fact that almost half of the current study participants are in the acute phase of their stroke recovery as they had a duration since the stroke onset of less than 1 month, and it was their first stroke; such patients are expected to have higher levels of anxiety. 17,18 It may also be explained by the lack of early detection of anxiety and provision of appropriate interventions and support amongst the study participants. This is specifically true knowing that all recruited patients were in hospitals where special care for patients with stroke is not found, including routine screening for anxiety, which otherwise would be effective in reducing the prevalence of anxiety post-stroke.…”

Section: Discussionmentioning

confidence: 99%

Post-stroke Anxiety Among Patients in Jordan: A Multihospital Study

Ayasrah

Ahmad

Basheti

et al. 2021

J Geriatr Psychiatry Neurol

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This study aimed to assess the prevalence, correlates, and significant associated factors of anxiety among patients with stroke. A cross-sectional, correlation design was utilized. The Hospital Anxiety and Depression scale was used to detect and assess the severity of anxiety and depression among mentally well patients at general hospital settings. Among the 226 patients with stroke, 45.6% had clinically significant levels of anxiety to be considered as a definite case. Having a short duration since the stroke onset, being a definite case of depression, being unable to perform self-care activities, having an insufficient monthly income, and having visual problems due to stroke were the significantly associated factors. The high prevalence of anxiety among patients with stroke highlights the need for interventions of early detection and management to enhance recovery. Patients who have any of the significant traits predicted post-stroke anxiety required special attention.

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“…As stated in the published study [ 26 ] an experienced physiotherapist who was blinded assessed participants. The inclusion criteria were: ischaemic or haemorrhagic stroke confirmed according to World Health Organization (WHO) criteria [ 27 ]; age 18 years or older; residence within 30 min by car of the stroke unit; a National Institute of Health Stroke Scale (NIHSS) [ 28 , 29 ] score of 0–16 points, which corresponds to mild-to-moderate stroke [ 30 ]; a Barthel Index (BI) [ 31 ] score of 50 points or more on day 2 [ 32 ]; and a Montreal Cognitive Assessment [ 33 ] index of 26 points or less if BI = 100.…”

Section: Methodsmentioning

confidence: 99%

Self-perceived postural balance correlates with postural balance and anxiety during the first year after stroke: a part of the randomized controlled GOTVED study

2020

Self Cite

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Background Postural balance is an important rehabilitation outcome, and screening stroke patients for confidence in postural balance during rehabilitation and before hospital discharge is recommended. Early supported discharge could improve postural balance self-confidence. This study aimed to investigate associations between patient self-confidence in postural balance and observer-assessed postural balance and anxiety during the first year after stroke. Whether very early supported discharge (VESD) affects self-confidence in postural balance compared with standard discharge was also evaluated. Methods A longitudinal trial for with data extracted from a randomized controlled study of 140 adults with confirmed stroke was conducted. The experimental group received VESD. The control group was discharged according to the standard routine. Postural balance was assessed with Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Falls Efficacy Scale. Anxiety was assessed with the Hospital Anxiety and Depression Scale. Spearman’s rank correlation coefficient (rho) was used to test associations between independent variables. The Wilcoxon signed-rank test was used to examine differences over time. A single test, according to Eid, Gollwitzer, and Schmidt, was used to test temporal differences in correlation. Results The correlation between self-confidence in postural balance and observer-assessed postural balance was 0.62–0.78 in the first year after stroke. The correlation between self-confidence and anxiety was 0.22–0.41 in the first year after stroke. Correlations did not differ by group affiliation at any time point when the postural balance was assessed with BBS. The intervention group had a significantly higher correlation (r = − 0.709) than the control group (r = − 0.416) when postural balance was assessed with the TUG test 1 month after discharge. There were no significant differences in correlations between confidence in postural balance and anxiety between the two groups at any time point. Conclusions Patients with mild stroke can accurately assess their confidence in performing daily activities without falling. VESD does not substantially affect the correlation between self-confidence in postural balance and observer assessed postural balance and is safe to use as an alternative to standard discharge. Assessment of self-confidence can provide important information for rehabilitation planning and supporting the physical activity of patients after discharge. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).

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Gothenburg Very Early Supported Discharge study (GOTVED): a randomised controlled trial investigating anxiety and overall disability in the first year after stroke

Cited by 16 publications

References 35 publications

Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis

Early Supported Discharge and Transitional Care Management After Stroke: A Systematic Review and Meta-Analysis

Post-stroke Anxiety Among Patients in Jordan: A Multihospital Study

Self-perceived postural balance correlates with postural balance and anxiety during the first year after stroke: a part of the randomized controlled GOTVED study

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