Formal and informal care after stroke: A longitudinal analysis of survivors’ post rehabilitation hospital discharge

To describe the type and the amount of formal and informal care received during the first year after home discharge and to identify the baseline predictors of the formal and informal care needs of stroke survivors.Longitudinal study. Data were collected between June 2013-May 2016.Survivors (N = 415) were enrolled during discharge from rehabilitation hospitals and interviewed at 3 (T1), 6 (T2), 9 (T3), and 12 (T4) months. The linear mixed effects model with random intercept and random slopes was used to trend for the amount of formal and informal care received by survivors during the four observation times.Regarding formal care, only physiotherapy and speech therapy decreased significantly over time. Stroke survivors received a mean of 17 hr of paid informal care per week at T1 and these hours did not significantly decrease after one year from discharge, while unpaid informal care decreased significantly over time. Higher numbers of paid informal caregiving were predicted by older age, higher education levels, lower physical functioning, and living without unpaid informal caregivers while higher numbers of unpaid informal care were predicted by lower physical functioning and living with unpaid informal caregivers.Stroke has a great effect on survivors' lives. During the first few months after rehabilitation hospital discharge, survivors need further care because they are often discharged before achieving independent functioning.The results of this study could be important to guide future interventions aimed at imporving stroke survivors' conditions after post rehabilitation hospital discharge.目的: 在于描述出院后第一年接受正式和非正式护理的类型和数量,并确定中风幸存者正式和非正式护理需求的基线预测指标。 设计: 纵向分析。2013年6月至2016年5月期间,收集了相关数据。 方法: 幸存者(415名)在康复医院出院时登记,并在3个月(T1)、6个月(T2)、9个月(T3)和12个月(T4)接受访谈。使用了具备随机截距和随机斜率的线性混合效应模型来预测幸存者在四次观察期间接受的正式和非正式护理数量。 结果: 关于正式护理,随着时间的推移,只有物理疗法和语言疗法在显著减少。中风幸存者在T1时每周平均接受17小时的有偿非正式护理,出院一年后这些时间没有显著减少,而无偿非正式护理却随着时间的推移显著减少。年龄越大、受教育水平越高、身体机能越差以及没有无酬非正式护理人员的生活预示着有酬非正式护理的人数会越来越多,而身体机能越差和与无酬非正式护理人员的生活预示着无酬非正式护理的人数会越来越多。 结论: 中风对幸存者的生活有很大影响。在康复医院出院后的头几个月里,幸存者需要进一步的护理,原因在于他们通常在能独立活动之前就出院了。 影响: 这项研究的结果对于指导旨在改善康复出院后中风幸存者状况的未来干预措施非常重要。.