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Long-term effects of the intensification of the transition between inpatient neurological rehabilitation and home care of stroke patients.

Abstract：

OBJECTIVE:To investigate an intensified transition concept between neurological inpatient rehabilitation and home care for long-term effects on the care situation two and a half years after stroke patients' discharge. DESIGN:Controlled clinical trial allocating patients to intervention group (intensified transition on ward II) or control group (standard transition on ward I); patients were allocated to whichever ward had a vacancy. The last follow-up assessment was carried out on average 31 months after discharge. INTERVENTION:The intensified transition concept consisted of therapeutic weekend care, bedside teaching and structured information for relatives during the second phase of the rehabilitation. SUBJECTS:Seventy-one patients and their family carers were included, of which one case dropped out. Therefore 70 family carers--35 individuals in each group-- were available for assessment at long-term follow-up. DATA COLLECTION:Family carers were asked via telephone whether the patient was still alive and if so, where he or she is living--at home or in a nursing home. STATISTICAL METHODS:Binary logistic regression analysis with the care situation (home care versus institutionalized care or deceased) as dependent variable. RESULTS:Two and a half years after discharge (T3) in the intervention group significantly fewer patients were institutionalized (2 versus 5) or deceased (4 versus 11) (P = 0.010). Multivariate analysis showed that besides a higher functional life quality at discharge and lower patient's age, the participation in the intensified transition programme is the third significant predictor for home care at T3. CONCLUSION:Effects of an intensified transition programme can persist over a long-term period. They can sustain home care by reducing institutionalization and mortality.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

Gräsel E,Schmidt R,Biehler J,Schupp W

doi

10.1191/0269215506cr978oa

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

577-83

issue

eissn

0269-2155

issn

1477-0873

journal_volume

pub_type

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Long-term effects of the intensification of the transition between inpatient neurological rehabilitation and home care of stroke patients.