TITLE:
Evaluation of a rehabilitation support service after acute stroke: Feasibility and patient/carer benefit
AUTHORS:
Joanna J. McAdam, Michael J. Leathley, Margaret S. Crichton, Julie Dickens, Cathy I. A. Jack, Caroline L. Watkins
KEYWORDS:
Stroke; Rehabilitation; Activities of Daily Living; Instrumental Activities of Daily Living
JOURNAL NAME:
Health,
Vol.5 No.7,
July
22,
2013
ABSTRACT:
Background: Stroke survivors returning home after discharge from
hospital and their carers require support to meet their rehabilitation needs
(independence in Activities of Daily Living, exercise, psychosocial support).
Voluntary or charitable care providers may be able to address some of these needs.
Objective: To explore the feasibility of delivering and evaluating enhanced
support to stroke survivors and their carers, with a Rehabilitation Support
Worker (RSW). Methods: 16 consecutive
stroke survivors and their carers were included. All participants received
usual hospital care. Seven of these patients and their carers were also allocated
an RSW from a charitable care provider. The RSW accompanied therapy training sessions with the patient, carer and therapist in hospital. On discharge, the RSW
visited the patient and carer at home over the initial 6 week post-discharge
period to support them in practising rehabilitation skills. Patient function
(Barthel Index) and patient/carer confidence were independently assessed at discharge
(Week 0). The above assessments and patient/carer mood (GHQ-12) and Carer
Giver Strain were also assessed at Weeks 1, 6 and 12. RSWs were interviewed for
their views about the service. Results: Participants’ functional ability at Week
1 post-discharge was significantly higher in the RSW group. At 6 and 12 weeks
post-discharge, functional ability was not significantly different between
groups. Carers in the intervention group were less confident at all time
points, however, this was not significant. There was no significant effect on
carer strain or well-being. Interviews with RSWs highlighted areas of their training that could be
enhanced and the need for greater clarity as to their role. Conclusions: The results showed that a
definitive trial of rehabilitation support is feasible. A number of obstacles
however would need to be overcome including: difficulty in identifying suitable
patients, clarity of the RSW role, and appropriate training content.