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Rehabilitation Practice and Science

Translated Title

探討腦中風居家模式急性後期照護之成效及預測因子

Abstract

Introduction: Stroke is the leading cause of disability in adults. In 2014, Taiwan's National Health Insurance Administration started to provide inpatient postacute care, and the results indicated that this model improves the overall functional status of patients with stroke. In 2017, home-based postacute stroke care was initiated; however, no study has evaluated its effectiveness. Therefore, we explored the functional recovery of patients with stroke after 6 weeks of postacute care at home and the factors that influenced their functional improvement. Method: We recruited patients with stroke who received a score of 3 or 4 on the modified Rankin Scale between 2019 and 2021 from a district hospital and underwent 6 weeks of postacute care at home. Their scores on the Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Functional Oral Intake Scale (FOIS) and EuroQol-5 Dimensions (EQ5D) at pretreatment, after 3 weeks of treatment, and after 6 weeks of treatment (i.e., end of treatment) were statistically analyzed. Result: We recruited 102 patients with stroke and compared the differences in their scores on the aforementioned scales at pretreatment, after 3 weeks of treatment, and after 6 weeks of treatment (i.e., end of treatment). The results revealed that after 6 weeks of postacute care at home, the patients' scores on the Barthel index, instrumental activities of daily living scale, functional oral intake scale, and health-related quality of life scale all increased significantly. Furthermore, the scores acquired after 6 weeks of treatment indicated a significant and continual functional progress relative to those acquired after 3 weeks of treatment (P ＜ 0.05). A multivariable regression revealed that malnutrition was the independent predictor that affected the patients' improvement in their activities of daily living (P ＜ 0.05). Conclusion: For patients who experienced a moderate to severe level of functional impairment within 1 month after a stroke, a 6-week home-based postacute care program can significantly improve their activities of daily living, instrumental activities of daily living scale, swallowing function, and quality of life. The treatment can serve as an option for patients with stroke during a crucial period of their postacute rehabilitation.

Language

Traditional Chinese

First Page

115

Last Page

123

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