This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gräsel, E Articles by Schupp, W Search for Related Content PubMed PubMed Citation Articles by Gräsel, E Articles by Schupp, W Social Bookmarking                   What's this?

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

Clinic for Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Herzogenaurach, Bavaria, Germany

R Schmidt

Clinic for In-and Outpatient Rehabilitation Medicine, Herzogenaurach, Bavaria, Germany

J Biehler

Clinic for Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Herzogenaurach, Bavaria, Germany

W Schupp

Clinic for In-and Outpatient Rehabilitation Medicine, Herzogenaurach, Bavaria, Germany

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.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?