The effectiveness of discharge planning stroke patient due to hypertension to improve patient satisfaction and independence

Managing Post-Stroke Care During the COVID-19 Pandemic at a Tertiary Care Level Hospital in Peru

OBJECTIVES

To understand the hospital-to-outpatient care transition and how the discharge process of stroke patients is managed; and to identify potential opportunities to improve these processes, while contrasting pre- and during COVID-19 experiences in Peru.

METHODS

A qualitative study was conducted between February and March 2021 consisting of in-depth interviews of patients with stroke, their caregivers and healthcare personnel regarding stroke care at a national tertiary referral center for stroke care in Lima, Peru. We explored the following phases of the patients' journeys: pre-hospitalization, emergency room, hospitalization, discharge process and post-discharge. For each phase, we explored experiences, feelings and expectations using thematic analysis.

RESULTS

We conducted a total of 11 interviews with patients or caregivers and 7 with health care personnel and found disruption in the continuity of care for patients with stroke. Mainly, caregivers and patients referred to problems related to communication with healthcare personnel and an absence of training to provide post-discharge care at home. Potential solutions included increasing human resources and caregiver participation in care, implementation of electronic healthcare records, improving the referral system and reinforcing telemedicine services.

CONCLUSION

The continuity of care of patients with stroke was negatively affected during the COVID-19 pandemic. In LMICs, the impact was likely greater due to the already weak and fragmented healthcare systems. The COVID-19 pandemic presents an opportunity to improve post-stroke care services, and address patients' experiences and feelings by developing solutions in a participatory manner.

Intervention Effect of Rapid Rehabilitation Nursing Combined with Continuous Nursing after Discharge on Patients with Cerebral Infarction in Recovery Period and the Changes in Motor Function, Mental State, and Quality of Life

OBJECTIVE

To explore the effect of rapid rehabilitation nursing combined with continuous nursing after discharge on patients with cerebral infarction (CI) in recovery period and its influence on motor function, mental state, and quality of life.

METHODS

From January 2018 to December 2020, 136 patients with CI in recovery period were selected and randomly divided into control group (n = 68) and observation group (n = 68). The control group was given routine nursing, and the observation group was given rapid rehabilitation nursing combined with continuous nursing after discharge. The general clinical data of the two groups were recorded, and the nursing efficiency, modified Barthel index scale (MBI), stroke patients motor assessment scale (MAS), self-rating anxiety and depression scale (SAS and SDS), and quality of life assessment scale (QLI) were compared between the two groups.

RESULTS

The nursing effective rate of the observation group (94.12%, 64/68) was higher than that of the control group (82.35%, 56/68) (P < 0.05). The MBI score, MAS score, and QLI score in the observation group were higher than those in the control group, while the SAS and SDS scores in the observation group were lower than those in the control group (P < 0.05).

CONCLUSION

Rapid rehabilitation nursing combined with continuous nursing after discharge can promote the rapid recovery of patients with CI in recovery period, which can improve the patient's motor function, reduce unhealthy psychology, and improve the quality of life.

Impacts of tailored, rehabilitation nursing care on functional ability and quality of life in hospitalized elderly patients after rib fractures

OBJECTIVES

We aimed to analyze the effects of a tailored rehabilitation nursing care program on functional ability and quality of life in patients with conservative treatment for rib fractures.

DESIGN

Randomized controlled trial.

SETTING

Inpatient rehabilitation hospital.

SUBJECTS

Rib fracture patients treated conservatively were randomized into two groups (experimental and control group).

INTERVENTIONS

Patients in control group received Treatment as Usual (TAU) and patients included in experimental group received TAU and an added tailored rehabilitation nursing care program (RNT).

MAIN MEASURES

At baseline, and end of hospitalization treatment, the functional ability was assessed with the Barthel Index, and the quality of life was evaluated with the EuroQol-5D. Additionally, the outcomes were assessed at six-month follow-up.

RESULTS

A total of 80 patients were included in the study, whose mean age was 77.19 SD 7.71 in the RNT group and 75.55 SD 9.46 in the TAU group. Our data showed a significant difference in the post-treatment gains in overall quality of life (74.25 SD 20.62 vs 60.28 SD 20.54), and functional ability (71.79 SD 23.85 vs 69.41 SD 24.30) between the RNT group and the TAU group (P < 0.05). Compared to the TAU group, the RNT group also showed a significant improvement in functional ability and quality of life at six-month follow-up.

CONCLUSIONS

A tailored rehabilitation nursing care program added to the conservative treatment during hospitalization can improve the functional ability and quality of life of patients after rib fractures at discharge and at six-month follow-up.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier: NCT04168996.