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BMC Health Services Research
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Stroke | Research

Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs

Authors: Geraldine O’Callaghan, Martin Fahy, Sigrid O’Meara, Mairead Chawke, Eithne Waldron, Marie Corry, Sinead Gallagher, Catriona Coyne, Julie Lynch, Emma Kennedy, Thomas Walsh, Hilary Cronin, Niamh Hannon, Clare Fallon, David J Williams, Peter Langhorne, Rose Galvin, Frances Horgan

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Introduction

Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter.

Methods

A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7–10 days, and at 3-, and 6-months, post-discharge.

Results

72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0–20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were “fair” at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1–9), and three (range:1–7) at 6-months.

Conclusion

Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture.

ISRCTN registration

02/08/2022; ISRCTN44633579.
Appendix
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Metadata
Title
Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs
Authors
Geraldine O’Callaghan
Martin Fahy
Sigrid O’Meara
Mairead Chawke
Eithne Waldron
Marie Corry
Sinead Gallagher
Catriona Coyne
Julie Lynch
Emma Kennedy
Thomas Walsh
Hilary Cronin
Niamh Hannon
Clare Fallon
David J Williams
Peter Langhorne
Rose Galvin
Frances Horgan
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10820-8

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