Patient Preference for Community-based Rehabilitation Programs after Stroke

Lee, Han-Suk; Ann, Chang Sik; Kim, Myung Chul; Choi, Jin Ho; Comt, Goon Chang Yuk, Pt, PhD,

doi:10.1589/jpts.23.137

Cited by 8 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…880 Benefits associated with community-and home-based rehabilitation programs have been reported for a variety of outcomes, including reduced costs, decreased length of stay in hospitals or institutional settings, more opportunity for patient and family involvement in the treatment process, and less stress on caregivers and family members. 881,882 It has also been consistently reported that individuals recovering from a stroke and their family members or caregivers prefer home-or community-based rehabilitation programs over center-or institutionally located rehabilitation services for a variety of practical and personal reasons. 881 Patient satisfaction with home-based rehabilitation programs is generally higher than for institutionally based alternatives.…”

Section: Referral To Community Resourcesmentioning

confidence: 99%

“…881 Patient satisfaction with home-based rehabilitation programs is generally higher than for institutionally based alternatives. 882 Because the potential for recovery exists regardless of age and time after stroke and because fewer financial resources appear to be dedicated to providing optimal care during the later phases of stroke recovery, family caregiver education and support are recommended. Intervention, referrals, and follow-up care based on detailed caregiver assessments conducted during the survivor's inpatient stay are likely to smooth the transition of care to the home setting.…”

Section: Referral To Community Resourcesmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,046

840

View full text Add to dashboard Cite

e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

show abstract

Section: Referral To Community Resourcesmentioning

confidence: 99%

Section: Referral To Community Resourcesmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,046

840

View full text Add to dashboard Cite

show abstract

“…This factor of lower education level also indirectly affected caregiver QoL through caregiver burden as a mediator. Lower education might be associated with less ability to understand the process of caring for a first-time stroke patient and decrease the adaptability of the roles as a caregiver [ 29 , 34 ]. Therefore, lower education may contribute to higher caregiver burden as well as to a lower caregiver QoL.…”

Section: Discussionmentioning

confidence: 99%

Mediating effects of burden on quality of life for caregivers of first-time stroke patients discharged from the hospital within one year

et al. 2018

View full text Add to dashboard Cite

BackgroundCaregiver burden may be either a predictor or an outcome of caregiver quality of life (QoL). Patient or caregiver factors that directly affect caregiver QoL, predictors that are simultaneously shared with caregiver burden and QoL, and factors that affect caregiver QoL through caregiver burden are not well understood. This study explored predictors of caregiver QoL and identified whether caregiver burden is a mediator for caregivers of first-time stroke patients.MethodsThis is a cross-sectional study. We recruited first-time stroke patients who had been discharged from the hospital within 1 year. We screened caregivers with two major inclusion criteria: age > 20 years old and being the family member who provides the most patient-care hours out of all family caregivers. Caregiver burden (Caregiver Strain Index, CSI), QoL (Caregiver Quality of Life Index, CQLI), and patient and caregiver characteristics were assessed with structured questionnaires. Multiple-regression and bootstrap analysis were conducted for data analysis.ResultsA total of 126 caregivers completed the questionnaires. Higher caregiver burdens, lower caregiver education level, lower self-rated health, lower monthly family income, and spouses who were responsible for medical fees were significant predictors of lower caregiver QoL. Poor self-rated health and monthly family income of $ 666 USD or below were the strongest predictors of caregiver QoL. Spouses who were responsible for medical fees and lower monthly family income had direct negative effects on caregiver QoL, but these factors exhibited no indirect mediating effect between caregiver characteristics and QoL through caregiver burden as a mediator. Caregiver education level at or below elementary school and poor or fair self-rated-health had direct negative effects on caregiver QoL, which were mediated by caregiver burden.ConclusionsOur study indicated predictors of caregiver QoL and the relationships with caregiver burden among first-time stroke survivors in the early stage. Caregivers’ financial factors affected caregiver QoL directly. Caregivers’ poor self-rated health and lower education level negatively affected caregiver QoL indirectly through caregiver burden as a mediator. Interventions to make appropriate policies for financial subsidies, to enhance caregivers’ health and to provide tailored stroke-related education through multidisciplinary cooperation may effectively promote caregiver QoL.

show abstract

“…Our cumulative survival analysis showed a significantly lower cumulative incidence of PU during the 12-year follow-up period in the high-intensity rehabilitation group. Community- and home-based rehabilitation programs have various benefits, including reduced costs, decreased length of stay in hospitals or institutional settings, more opportunity for involvement of patients and their family in the treatment process, and less stress on caregivers and family members [ 35 , 36 ]. Some community-based rehabilitation intervention trials demonstrated enhanced ambulation and mobility, better self-care, and greater functional independence [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

High-Intensity Post-Stroke Rehabilitation Is Associated with Lower Risk of Pressure Ulcer Development in Patients with Stroke: Real-World Evidence from a Nationwide, Population-Based Cohort Study

Chen

Cheng

et al. 2022

Medicina

View full text Add to dashboard Cite

Background and Objectives: Multiple factors are associated with pressure ulcer (PU) development, including limited mobility following stroke. We performed a nationwide cohort study to investigate the impact of rehabilitation intensity on the incidence of post-stroke PU. Materials and Methods: Data of patients diagnosed with stroke between 2000 and 2012 were collected from the 2000 Longitudinal Health Insurance Database (Taiwan). Based on the number of rehabilitation sessions attended within 90 days of discharge, the rehabilitation intensity was classified as low, medium, or high. After adjusting for sociodemographic factors and comorbidities, the Cox proportional hazards model evaluated the risk of PU development during the 12-year follow-up period. Kaplan–Meier curves were used to estimate the cumulative incidence of PUs. Results: Our study included 18,971 patients who had their first episode of stroke. Of these, 9829 (51.8%) underwent rehabilitation therapy after discharge. Female patients and patients with a National Institutes of Health Stroke Scale (NIHSS) score >13 points, who commenced high-intensity post-stroke rehabilitation after discharge had a significantly lower risk of PU development than those who underwent low-intensity post-stroke rehabilitation after discharge. Cumulative survival analysis showed a significantly lower cumulative incidence of PU during the 12-year follow-up period in the high-intensity rehabilitation group. Conclusion: Compared with low-intensity post-stroke rehabilitation, high-intensity post-stroke rehabilitation after discharge from hospital is associated with a lower risk of post-stroke PU development, especially in female stroke patients and patients with a NIHSS score >13 points. High-intensity rehabilitation is also associated with a significantly lower cumulative incidence of PU events during the 12-year follow-up period.

show abstract

Patient Preference for Community-based Rehabilitation Programs after Stroke

Cited by 8 publications

References 5 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Mediating effects of burden on quality of life for caregivers of first-time stroke patients discharged from the hospital within one year

High-Intensity Post-Stroke Rehabilitation Is Associated with Lower Risk of Pressure Ulcer Development in Patients with Stroke: Real-World Evidence from a Nationwide, Population-Based Cohort Study

Contact Info

Product

Resources

About