Department of Clinical Teaching and Research, School of Nursing, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan Province, 450000 P.R. China
Background: Stroke is the leading cause of morbidity, mortality, and disability among adults in China. There are more than 2 million new stroke patients every year, more than 1.8 million deaths from stroke each year, and a 75% disability rate among sur- vivors. After hospital treatment, transitional care could help ensure improved patient care and outcomes and reduce medical costs and readmission rates. Nevertheless, the intervention effect of transitional care on the functional exercise compliance and health sta- tus of stroke patients has not been reported in mainland China.
Objectives: To examine the effectiveness of a nurse-led transitional care model on the functional exercise compliance and health status of Chinese stroke patients.
Methods: The sample comprised 40 Chinese stroke patients. The intervention group (n = 20) received one month of nurse-led transitional care intervention, which included discharge assessment and a personalized transitional care plan and health education for the patients based on the results of the assessment, followed by 1 month of individual guidance (home visits and telephone follow- up). The control group (n = 20) received routine instructions at discharge, including instructions on functional exercise, daily care, dietary guidance, psychological care, and medication guidance. Functional exercise compliance and health status were monitored in both groups before the intervention and one, three, and six months after the end of transitional care to evaluate the intervention out- comes.
Results: No significant between-group differences were observed in functional exercise compliance or health status before the intervention was conducted. One month after the intervention, functional exercise compliance and health status were significantly improved in the intervention group, with significant between-group differences in all but one dimension: social functioning. Three months after the intervention, functional exercise compliance and four dimensions of health status – physical functioning (PF), role limitations due to physical health problems (RP), general health perceptions (GH), and mental health (MH) – were significantly improved in the intervention group compared with the control group. Six months after the intervention, only the active advice-seeking of functional exercise compliance and the GH of health status were significantly improved in the intervention group compared with the control group.
Conclusion: A nurse-led transitional care intervention effectively improved the early functional exercise compliance and health status of stroke patients. However, the intervention effect decreased with time after the intervention, and the long-term effect was not ideal.
Transitional care, stroke, functional exercise, health status