Development, implementation and evaluation of a structural stroke education program for informal caregivers of stroke patients

Background and purpose: Interdicipinary education program of stroke unit might be important to improve secondary prevention by increase of medication compliance and maintenance of relationship with physician. The present study evaluated that our education program of stroke unit including education materials for stroke prevention and man-to-man education schedule of stroke unit is helpful to increase the medication compliance and future follow-up rate for first-ever stroke patients. Methods: We first developed education materials, which were consisted of mechanisms and clinical characteristics of stroke, and importance of medication maintenance for secondary stroke prevention. Then man-to-man education was provided for patients who admitted stroke unit (Education group) from January to June of 2012. Medication maintenance rate at 3 months and follow-up rates checked 1 and 3 months after discharge were evaluated. Then, to evaluate the education effects, the rates of Education group were compared ones of No-Education group who were treated in general ward with no organized stroke education from January to June of 2010. Results: Total 392 patients (178; No-Education, 214; Education group) were enrolled. Among patients who admitted to stroke unit, 96.7% were educated by 2 stroke coordinators during admission period. The follow-up rates after discharge were slightly higher in Education group within 1month (89% vs 82%, p <0.05). Maintenance of the follow-up was significantly higher in Education group after 3months (83% vs 61%, p <0.05) than No-Education group. Maintenance rates of antithrombotic medication was highly achieved in the Education group (98% vs 89%, p <0.05) during follow-up period of 3 months. Conclusions: We observed that the educational effect of stroke unit is well maintained till 3 months after discharge. The high follow-up rate and good medication compliance could be obvious benefits of interdisciplinary working stroke unit.

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Abstract NS5: Improvement of Follow-up Rate After Discharge of Acute Ischemic Stroke Patients by the Man-to-man Education for Stroke During Admission

Stroke ◽

10.1161/str.47.suppl_1.ns5 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Hee Sun Yu ◽

Na Young Yun ◽

Jong Wook Shin ◽

Hye Seon Jeong ◽

Sangeun Yoo ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Education Program ◽

Drug Information ◽

Warning Signs ◽

Stroke Patients ◽

Nutrition Behavior ◽

Number Of Patients ◽

Stroke Education

Background: We have executed a man-to-man stroke education program for acute ischemic stroke patients during admission since 2012. The contents of the man-to-man stroke education includes warning signs of stroke, guidance for prompt actions after symptom onset, drug information, and exercise and nutrition behavior after discharge. We evaluated whether the man-to-man education given during admission is effective to improve follow-up rates after discharge for acute ischemic stroke patients. Methods: We compared clinical data including modified Rankin Scale (mRS) at discharge and length of stay and follow-up data after discharge of 697 acute ischemic stroke patients (Male:Female=283:414, mean age±SD, 69.0±12.1 years) admitted in 2013, who received the man-to-man education during admission, with the data of 602 patients (M:F=254:348, 67.1±12.2 years) admitted in 2008, who did not receive the active education during admission. To evaluate follow-up rates, we first checked the follow-up status of all included patients within 1, 4, 8, 12, 16 months after discharge. Then, follow-up rates at each time point were calculated as the ratio of the number of patients followed at the point to the all patients discharged in 2008 or 2013. Differences of the follow-up rates between 2008 and 2013 were compared at individual follow-up time points using one-sided x2-test. Results: Even though the favorable outcome defined as 0-3 of mRS at discharge was similar between 2008 and 2013 (2008 vs. 2013, 88.3 vs. 87.4%, p=0.342), length of admission was significantly shorter in 2013 than 2008 (2008 vs. 2013, 10.2 vs. 6.6 days, p<0.001). On follow-up rates evaluations, follow-up at 1 month was significantly higher in 2013 (89.8%) than 2008 patients (83.7%) (p=0.001). The follow-up rates subsequently decreased at 4months (2008 vs. 2013, 77.3 vs. 81.5%, p=0.040), 8 months (70.1 vs. 74.3%, p=0.051), 12 months (63.1vs. 67.6%, p=0.052), and 16 months (57.6 vs. 63.0%, p=0.028). However, the follow-up rates of 2013 patients was consistently higher than 2008 ones. Conclusion: The present data suggested that active education program for acute ischemic stroke patients could improve to follow-up rates of the patients after discharge.

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Stroke Education for Multidisciplinary Medical Personnel in a Rural Area of Japan for Promotion of Hospital Visit of Acute Stroke Patients

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2014.05.010 ◽

2014 ◽

Vol 23 (9) ◽

pp. 2372-2377 ◽

Cited By ~ 2

Author(s):

Hiroyuki Kawano ◽

Chiaki Yokota ◽

Fumio Yamamoto ◽

Yoshiteru Mori ◽

Yosuke Mihara ◽

...

Keyword(s):

Acute Stroke ◽

Rural Area ◽

Medical Personnel ◽

Stroke Patients ◽

Hospital Visit ◽

Stroke Education

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Abstract T P251: Factors for Delayed Medical Care Seeking among Elderly Stroke Patients in Korea

Stroke ◽

10.1161/str.45.suppl_1.tp251 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Jeongha sim ◽

Dongchoon Ahn ◽

cha-nam shin

Keyword(s):

Ischemic Stroke ◽

Medical Care ◽

Acute Ischemic Stroke ◽

Statistical Significance ◽

Care Seeking ◽

Stroke Patients ◽

Convenience Sample ◽

Hospital Arrival ◽

Stroke Education ◽

Korean Elderly

Background: Stroke is the second leading cause of death in Korea and the prevalence of acute ischemic stroke among older adults continues to grow, which is known to be related to delayed hospital arrival after the onset of symptoms. Thus, decreasing the incidence of elderly stroke is a major health promotion objective in Korea, yet little is reported about the factors associated with the delayed medical care seeking behavior among elderly stroke patients in Korea. Purpose: The purpose of this study was to understand factors of delayed medical care seeking among elderly stroke patients in order to develop intervention strategies to improve the health of this population. Methods: A cross-sectional, descriptive study was conducted in a convenience sample of 233 hospitalized elderly patients with acute ischemic stroke using a self-administered survey. Descriptive statistics and chi-square test were used for data analysis. Results: More than half of them were male (60.5%) with age of 61 and older (76.9%), and relied on the opinion of their children or friends when deciding medical care for stroke (58.3%). Regarding the reasons of seeking medical care, there was no statistical significance between individuals who arrived at a hospital within three hours of the onset of symptoms and who arrived after three hours. Reasons for delayed hospital arrival were significantly different between groups (individuals of hospital arrival within three hours vs. individuals with hospital arrival after three hours), which include lack of knowledge about the severity of stroke and unawareness of symptoms (χ2 = 24.1), or inconvenience of a hospital visit, waiting for the effects of alternative medications, and stroke during sleep (χ2 = 55.1) with p <0.001. Conclusions: In conclusion, this study helped identify factors delaying hospital arrival after the onset of symptoms among Korean elderly stroke patients. Interventions should include stroke education focusing on the severity of stroke and related symptoms. The stroke education should target not only elderly stroke patients but their family members and friends. It may result in overall national health by decreasing prevalence of stroke among Korean elderly population.

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Randomized Controlled Trial of a Comprehensive Stroke Education Program for Patients and Caregivers

Stroke ◽

10.1161/01.str.30.12.2585 ◽

1999 ◽

Vol 30 (12) ◽

pp. 2585-2591 ◽

Cited By ~ 148

Author(s):

Helen Rodgers ◽

Catherine Atkinson ◽

Senga Bond ◽

Michael Suddes ◽

Ruth Dobson ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Education Program ◽

Controlled Trial ◽

Randomized Controlled ◽

Stroke Education

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Long-term effects of a group support program and an individual support program for informal caregivers of stroke patients: which caregivers benefit the most?

Patient Education and Counseling ◽

10.1016/s0738-3991(01)00230-0 ◽

2002 ◽

Vol 47 (4) ◽

pp. 291-299 ◽

Cited By ~ 53

Author(s):

Elisabeth T.P van den Heuvel ◽

Luc P.de Witte ◽

Roy E Stewart ◽

Lidwien M Schure ◽

Robbert Sanderman ◽

...

Keyword(s):

Informal Caregivers ◽

Support Program ◽

Group Support ◽

Long Term Effects ◽

Stroke Patients ◽

Individual Support

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The capacity of informal caregivers in the rehabilitation of older people after a stroke

Investigación y Educación en Enfermería ◽

10.17533/udea.iee.v39n2e03 ◽

2021 ◽

Vol 39 (2) ◽

Author(s):

Mariane Lurdes Predebon ◽

Fernanda Laís Fengler Dal Pizzol ◽

Naiana Oliveira Dos Santos ◽

Carla Cristiane Becker Kottwitz Bierhals ◽

Idiane Rosset ◽

...

Keyword(s):

Health Care ◽

Older People ◽

Older Adult ◽

Informal Caregivers ◽

Descriptive Study ◽

Southern Brazil ◽

Older Person ◽

Stroke Patients ◽

Cross Sectional ◽

Sociodemographic Data

Objective. To characterize informal caregivers of dependent older people after a stroke related to aspects of care, and to describe the activities performed and the difficulties faced by these caregivers. Methods. Cross-sectional, descriptive study, held in southern Brazil with 190 informal caregivers of older adults after stroke. The sociodemographic data instrument and the Capacity Scale for Informal Caregivers of Elderly Stroke Patients (ECCIID-AVC), adapted and validated for use in Brazil by Dal Pizzol et al., were used. Results. Most caregivers were women (82.6%) or children (56.3%), had average schooling of 9.6 years, and the majority (68.3%) provided care for people with moderate to severe disability. The main activities carried out included: providing materials and/or support for eating (99%), dressing (98.4%), and administering medications (96.2%). Caregivers had the most difficulty with transferring and positioning activities. Conclusion. Most caregivers have adequate capacity to provide essential care to the dependent older adult after a stroke. However, a significant portion had difficulty in the activities of transferring and positioning the older person due to the lack of guidance regarding the posture to carry out these activities. The assessment of nurses regarding the activities performed and the difficulties faced by caregivers is an important strategy to identify problems and effectively attend to the needs of these individuals at all levels of health care.

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