TITLE:
Interaction between Caregiving Ability and Home Discharge Using Severity Classification upon Discharge
AUTHORS:
Takashi Kimura
KEYWORDS:
Interaction, Stroke, FIM, Discharge, Caregiving Ability
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.10 No.1,
January
7,
2022
ABSTRACT: Background: The interaction between self-care and caregiving
ability in home discharged stroke patients is unclear. Purpose: This
study investigates the interaction between caregiving ability and individual
self-care activities for post-stroke patients upon home
discharge based on their motor-Functional Independence Measure (m-FIM) score. Methods: A total of 2626 stroke
patients registered in the Japanese Rehabilitation Database were
retrospectively analyzed. Extracted data were divided into three groups based
on the m-FIM score at discharge and classified into two groups based on their
discharge destination (home discharge, non-home discharge). After the data were modified as mean-centered values, a
hierarchical multiple regression analysis evaluated the change in
variance amount (ΔR2) using discharge destination as the dependent
variable. Model 1 used two independent variables (Rankin Scale and cognitive
FIM score), model 2 used two independent variables
(caregiving ability and individual self-care), which were added to model
1, and model 3 used an interaction term value, which was added to model 2.
Furthermore, a simple slope analysis was performed for these interaction
effects. Results: The ΔR2 exhibited six and five self-care
items in the moderate and mild groups,
respectively. The interaction was significant on simple slope analysis in the
moderate group for six self-care items (except dressing upper body, toileting,
and bowel management) and in the mild group for three self-care items,
including dressing upper body, bladder management, and climbing stairs). Conclusion: This study suggests the need for intervention, especially
bladder management and single-foot standing ability during step climbing, in
stroke patients discharged to home. In addition, caregiving ability is one of the factors that should be
considered in mild group.