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Clin Interv Aging. 2014 Feb 12;9:283-91. doi: 10.2147/CIA.S56532. eCollection 2014.

Can short-term residential care for stroke rehabilitation help to reduce the institutionalization of stroke survivors?

Author information

1
School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.
2
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China.

Abstract

BACKGROUND:

Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap.

OBJECTIVES:

The primary objectives of this study were, first, to examine whether there were significant differences in terms of rehabilitation outcomes at 1 year after admission to the rehabilitation program (defined as baseline) between those using short-term residential care (intervention group) and those using usual geriatric day hospital care (control group), and, second, to investigate whether lower 1-year institutionalization rates were observed in the intervention group than in the control group.

PARTICIPANTS:

155 stroke survivors who completed at least the first follow-up at 4 months after baseline.

INTERVENTION:

The intervention group was stroke survivors using self-financed short-term residential care for stroke rehabilitation. The control group was stroke survivors using the usual care at a public geriatric day hospital.

MEASUREMENTS:

Assessments were conducted by trained research assistants using structured questionnaires at baseline, 4 months, and 1 year after baseline. The primary outcome measures included Modified Barthel Index score, Mini-Mental Status Examination score, and the institutionalization rate.

RESULTS:

Cognitive status (as measured by Mini-Mental Status Examination score) of patients in both groups could be maintained from 4 months to 1 year, whereas functional status (as measured by Modified Barthel Index score) of the patients could be further improved after 4 months up to 1 year. Meanwhile, insignificant between-group difference in rehabilitation outcomes was observed. The intervention participants had a significantly lower 1-year institutionalization rate (15.8%) than the control group (25.8%).

CONCLUSION:

Short-term residential care for stroke rehabilitation promoted improvements in rehabilitation outcomes comparable with, if not better than, the usual care at geriatric day hospital. Furthermore, it had a significantly lower 1-year institutionalization rate. This type of service could be promoted to prevent institutionalization.

KEYWORDS:

day hospital; institutionalization; rehabilitation; residential care; stroke

PMID:
24550670
PMCID:
PMC3926706
DOI:
10.2147/CIA.S56532
[Indexed for MEDLINE]
Free PMC Article

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