Washington: Stroke patients who come home from the hospital often feel unprepared and so are their caregivers, suggests a study. However, according to a study published in the journal 'Circulation: Cardiovascular Quality and Outcomes', when a home-based support network uses social work case managers and online resources, quality of life and confidence in managing one's health improves.
The study began with a series of focus groups conducted before the clinical trial where researchers asked stroke patients and caregivers about what worried them most. "Many of the participants said they left the hospital not really knowing what to do when they got home," said Michele Fritz, co-author of the study.
According to Fritz, 72 per cent of stroke patients felt unprepared to go home, 91 per cent were worried about having another stroke and 82 per cent didn't fully understand their medications, such as when to take them and what dosage they needed.
"This caused a lot of anxiety and worry," she said. "These patients get great care when they're in the hospital, but once they get home, they're often lost. It was important for us to really understand what mattered to them and then figure out what kind of support structure could alleviate the worry."
During the study, participants were chosen at random to receive the usual post-hospital care including leaving the hospital with standard stroke education materials, follow-up medical information, and referrals to out-patient doctor visits and rehabilitation services, if needed.
Another group was randomly assigned a social work case manager who offered emotional and practical support for up to 90 days after leaving the hospital. The remaining group of participants had access to the same case manager but were also given access to a patient website.
In total, 160 patients worked with a social work case manager. The three most common concerns included, nearly 70 per cent needed additional information about stroke, more than half wanted help to understand how to prevent another stroke and slightly more than one-third had financial concerns.
Patients with a case manager and the website reported significantly greater improvements in physical health by the end of the study compared to those who had traditional care. They also said they were more confident in taking control of their care. Those with access only to the case manager also reported some improvements but results were not as strong.
