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Researchers at Michigan State University found that many stroke patients did not feel prepared to exit the hospital. Their caregivers feel the same way.
But when a home support network using social work case managers and online resources is put in place, the quality of life and confidence in the management of its health improve, according to a new study published in the journal of the American Heart Association Circulation: quality and cardiovascular outcomes.
Developed by MSU, the Michigan Stroke Transitions Trial, or MISTT, tested three supportive strategies involving 265 convalescent patients and 169 informal caregivers, to determine which one worked best for home hospital transition.
The study began with a series of pre-clinical focus groups in which MSU researchers interviewed stroke patients and caregivers about what worried them the most.
Many participants said they left the hospital without knowing what to do when they returned home. "
Michele Fritz, epidemiologist and co-author, who worked with lead author Mathew Reeves at the Department of Epidemiology and Biostatistics at the MSU.
According to Fritz, 72% of stroke patients did not feel prepared to return home, 91% feared another stroke, and 82% did not understand their medications, for example when to take them and how much they had taken. need.
"This caused a lot of concern and concern," she said. "These patients receive great care when they are in the hospital, but once they get home, they are often lost.It was important for us to really understand what mattered to them and then determine what kind of structure support could ease the worry. "
During the study, participants were randomly selected to receive the usual post-hospital care that exists today. This includes leaving the hospital with standard stroke education materials, medical tracking information, and referrals to outpatient physician visits and rehabilitation services, if necessary.
Another group was randomly badigned to a social service case manager who offered emotional and practical support up to 90 days after leaving the hospital. The remaining group of participants had access to the same case manager, but also had access to a website for patients. The site, developed by the MISTT research team, provides unrestricted access to stroke education and support resources, including information on prevention and recovery, and useful information on stroke prevention. drug management and community resources and services.
A total of 160 patients worked with a case manager in social work. The three most common concerns included:
- Nearly 70% need additional information about stroke
- More than half want to help understand how to prevent another stroke
- A little over a third with financial problems
Patients with a case manager and website reported significantly greater improvements in physical health at the end of the study compared to those who benefited from traditional care. They also claimed to be more confident in caring for their care. Those who only had access to the case manager also reported some improvements, but the results were not as strong.
"When you add the website to the composition, we get better results," said Fritz.
However, some patients still had depression, regardless of their support program.
"This is an area in which we need to deepen our research," Fritz said. "It could mean that we need more time to improve the mental health of the participants – everything is difficult to measure, but we will continue to understand it in future studies."
Source:
University of Michigan
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