A Pilot Study to Evaluate the Feasibility and Effectiveness of Telecare Consultation in Nurse-led Post-acute Stroke Clinic
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- The Hong Kong Polytechnic University
- Enrollment
- 78
- Locations
- 1
- Primary Endpoint
- Degree of disability after stroke
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Introduction: The progress of stroke recovery is slow and enduring. If stroke survivors are not properly managed to facilitate their rehabilitation after discharged from hospital, their risk for recurrence after an index stroke will be very high. Globally, nurse-led post-acute stroke clinics have been developed to provide tertiary care services to support stroke survivors. While synthesized evidence supports the idea that the post-stroke services delivered by nurses in the clinic can improve the functional ability and reduce the readmission rate, shortcomings of these services such as compulsory traveling time and cost, long waiting time at the clinic, and the pandemic situation limit the clinic utilization by stroke survivors. Telecare consultation is a new modality aiming to provide a new healthcare access experience to the public, though how it can be applied in nurse-led clinic and what effects it can bring about on post-stroke survivors has not been reported.
Detailed Description
The aim of this pilot study is to determine the feasibility and effectiveness of telecare consultation in nurse-led post-acute stroke clinic. Method: The present pilot study adopts a one-group pre-test post-test design. The potential subjects will be recruited from the clinic in Queen Elizabeth Hospital if they are (1) having a confirmed diagnosis of stroke within 1 month before enrolment, (2) referred to nurse-led post-acute stroke clinic, (3) aged 18 or above, (4) cognitively competent with a score ≥ 22 in the Montreal Cognitive Assessment Hong Kong version, (5) living at home before and after discharged from the acute stroke unit, and (6) having a smartphone or living with family member who has a smartphone. The participants will receive two tertiary stroke care consultations provided by stroke nurses via telecare in 2 months. The outcome measures include feasibility (reasons for refusal and drop-out, acceptance and satisfaction of both the advanced practising nurses and their patients towards the program), and effectiveness (degree of disability after stroke, activity of daily living, instrumental activity of daily living, health-related quality of life, depression). Data will be collected at pre- (T1) and post- (T2) intervention. Discussion: The findings of this pilot study can provide a preliminary evidence on the use of telecare consultation in the nurse-led post-acute stroke clinic including its feasibility and effectiveness on both providers and patients. When gaps are identified, they could be adjusted to help develop and design a definitive, large-scale randomized controlled trial.
Investigators
Arkers, Wong
Assistant professor
The Hong Kong Polytechnic University
Eligibility Criteria
Inclusion Criteria
- •confirmed diagnosis of stroke within 1 month before enrolment
- •will be discharged home within a week
- •aged 18 or above
- •cognitively competent with a score equal to or greater than 22 in the Montreal Cognitive Assessment Hong Kong version
- •own a smartphone
Exclusion Criteria
- •have unaccompanied hearing or vision loss
- •cannot be reached by phone
- •no Internet connection at home
- •participating in other clinical trials at the same time
- •require physical contact, i.e. wound dressing
Outcomes
Primary Outcomes
Degree of disability after stroke
Time Frame: baseline, three months when the program is completed
Simplified modified Rankin scale will be used to measure the degree of disability for stroke patients.
Secondary Outcomes
- Quality of life(baseline, three months when the program is completed)
- Post-stroke depression(baseline, three months when the program is completed)
- Medication adherence(baseline, three months when the program is completed)
- Social participation(baseline, three months when the program is completed)
- Number of attendances at a general practitioner's office, emergency department, hospital, and general out-patient clinic(baseline, three months when the program is completed)