Feasibility, Fidelity and Acceptability of a Person-Centred Care Transition Support Intervention for Stroke Survivors: A Non-Randomised Controlled Study

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2024-10-07 DOI:10.1111/hex.70057

Sebastian Lindblom, Maria Flink, Lena von Koch, Ann Charlotte Laska, Charlotte Ytterberg

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引用次数: 0

Abstract

Background

Care transitions from hospital to home are a critical period for patients and their families, especially after a stroke. The aim of this study was to assess the feasibility, fidelity and acceptability of a co-designed care transition support for stroke survivors.

Methods

A non-randomised controlled feasibility study recruiting patients who had had stroke and who were to be discharged home and referred to a neurorehabilitation team in primary healthcare was conducted. Data on the feasibility of recruitment and fidelity of the intervention were collected continuously during the study with screening lists and checklists. Data on the perceived quality of care transition were collected at 1-week post-discharge with the Care Transition Measure. Data on participant characteristics, disease-related data and outcomes were collected at baseline (hospitalisation), 1 week and 3 months post-discharge. Data on the acceptability of the intervention from the perspective of healthcare professionals were collected at 3 months using the Normalisation Measure Development Questionnaire.

Results

Altogether, 49 stroke survivors were included in the study: 28 in the intervention group and 21 in the control group. The recruitment and data collection of patient characteristics, disease-related data, functioning and outcomes were feasible. The fidelity of the intervention differed in relation to the different components of the co-designed care transition support. The intervention was acceptable from the perspective of healthcare professionals. Concerns were raised about the fidelity of the intervention. A positive direction of effects of the intervention on the perceived quality of the care transition was found.

Conclusion

The study design, data collection, procedures and intervention were deemed feasible and acceptable. Modifications are needed to improve intervention fidelity by supporting healthcare professionals to apply the intervention. The feasibility study showed a positive direction of effect on perceived quality with the care transition, but a large-scale trial is needed to determine its effectiveness.

Patient or Public Contribution

Stroke survivors, significant others and healthcare professionals were involved in a co-design process, including the joint development of the intervention's components, contextual factors to consider, participant needs and important outcomes to target.

Trial Registration

ClinicalTrials.gov ID: NCT0292587.

查看原文本刊更多论文

针对中风幸存者的以人为本的护理过渡支持干预的可行性、忠实性和可接受性：非随机对照研究

背景：从医院到家庭的护理过渡是患者及其家庭的关键时期，尤其是在中风之后。本研究旨在评估为中风幸存者共同设计的护理过渡支持的可行性、忠实性和可接受性：一项非随机对照的可行性研究招募了中风患者，他们将出院回家并转诊至初级医疗保健机构的神经康复团队。在研究过程中，通过筛查名单和核对表不断收集有关招募可行性和干预忠实性的数据。出院后 1 周时，使用护理过渡测量法（Care Transition Measure）收集有关护理过渡感知质量的数据。在基线（住院）、出院后 1 周和 3 个月收集参与者特征、疾病相关数据和结果数据。在 3 个月时，从医护人员的角度使用正常化测量发展问卷收集干预措施的可接受性数据：共有 49 名中风幸存者参与了研究：干预组 28 人，对照组 21 人。患者特征、疾病相关数据、功能和结果的招募和数据收集都是可行的。干预措施的忠实度因共同设计的护理过渡支持的不同组成部分而异。从医护人员的角度来看，干预是可以接受的。有人对干预的忠实性表示担忧。研究发现，干预对护理过渡的感知质量具有正向影响：研究设计、数据收集、程序和干预被认为是可行和可接受的。需要对干预措施进行修改，通过支持医护人员应用干预措施来提高干预措施的忠实性。可行性研究表明，护理过渡对感知质量的影响方向是积极的，但需要进行大规模试验以确定其有效性：患者或公众的贡献：中风幸存者、重要他人和医护人员参与了共同设计过程，包括共同制定干预措施的组成部分、需要考虑的背景因素、参与者的需求以及目标的重要结果：试验注册：ClinicalTrials.gov ID：试验注册：ClinicalTrials.gov ID：NCT0292587。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.