Interdisciplinary Team Approach to Stroke Rehabilitation in Home Care
Completed
Phase 1 ResultsTrial Description
As the population ages and the number of stroke survivors increases, information is needed to determine the best way of providing home care services for rehabilitation to stroke survivors and their caregivers while containing health care costs. This project will address this area by developing and testing the effects and costs of a collaborative and specialized team approach to stroke rehabilitation by health professionals, in a home care setting, compared to usual home care services. The overall goal of this way of providing home care services is to improve the quality of life and function of stroke survivors and their caregivers and prevent future strokes, which will reduce the overall cost to the health care system.
Detailed Description
Stroke is the third leading cause of death in Canada, and is considered to be the most common disabling chronic condition. Approximately 40,000 to 50,000 people in Canada experience a stroke each year and about 80% of these people survive. Many of these people who survive a stroke never fully recover and are left with significant impairments and disabilities, and 12% to 25% will have another stroke within the first year. This results in a significant burden to individuals, families, and society as a whole. Of every 100 people who are hospitalized for a stroke, 15-40 return home and require home care services for rehabilitation. Stroke rehabilitation is one of the key components of stroke care. The goal of rehabilitation is to assist stroke survivors to reach his or her optimal level of physical, social, and emotional function.
Information gained from this study will be used to inform home care practice, policy decisions and the allocation of home care resources and make a national contribution to health care delivery reform.
Conditions
Interventions
- Interdisciplinary (or team) Stroke Rehab Behavioral
Intervention Desc: Participants in the experimental group will receive home care services from a team of professional service providers (CCAC Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist) and non-professional service providers (personal support workers) with experience and training in stroke care. The team will provide a comprehensive, coordinated and evidence-based approach to stroke rehabilitation through weekly case conferencing, a written interdisciplinary care plan, and joint visits. - Interprofessional Team Approach Other
Other Names: Interdisciplinary Stroke Rehabilitation Team Intervention Desc: Subject in the second group will receive home care services from a team of professional service providers (CCAC Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist) and non-professional service providers (personal support workers) with experience and training in stroke care. The team will provide a comprehensive, coordinated and evidence-based approach to stroke rehabilitation through weekly case conferencing, a written interdisciplinary care plan, and joint visits. ARM 1: Kind: Experimental Label: Interprofessional Team Approach Description: Participants in the experimental group will receive home care services from a team of professional service providers [Community Care Access Centre (CCAC) Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist] and non-professional service providers (personal support workers) with experience and training in stroke care. The team will provide a comprehensive, coordinated and evidence-based approach to stroke rehabilitation through weekly case conferencing, a written interdisciplinary care plan, and joint visits.
Trial Design
- Allocation: Randomized
- Masking: Double Blind (Investigator, Outcomes Assessor)
- Purpose: Treatment
- Endpoint: Efficacy Study
- Intervention: Parallel Assignment
Patient Involvement
Subjects will take baseline, 6-months and 12-months: Stroke Impact Scale - 16; Reintegration to Normal Living Index; Short Portable Mental Status Questionnaire; Centre for Epidemiological Studies in Depression Scale; Personal Resource Questionnaire; Health and Social Services Utilization Inventory; Kessler - 10Caregivers in study(measures taken at baseline and 12-months except the falls calendar): SF-36 health survey Centre for Epidemiological Studies in Depression Scale SPMSQ; Caregiver Reaction Assessment ScaleExperimental arm: Participants in the experimental group will receive home care services from a team of professional service providers (CCAC Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist) and non-professional service providers (personal support workers) with experience and training in stroke care.Interdisciplinary (or team) Stroke Rehab arm: Subject in the second group will receive home care services from a team of professional service providers (CCAC Care Coordinator, Registered Nurse, Occupational therapist, Physiotherapist, Speech language pathologist, Nutritionist) and non-professional service providers (personal support workers) with experience and training in stroke care.
Outcomes
Type | Measure | Time Frame | Safety Issue |
---|---|---|---|
Primary | For stroke survivors (measures taken at baseline, 6-months, and 12-months); Neurobehavioral Functioning Inventory. | ||
Secondary | For stroke survivors (measures taken at baseline, 6-months, and 12-months): Stroke Impact Scale - 16; Reintegration to Normal Living Index; Short Portable Mental Status Questionnaire; Centre for Epidemiological Studies in Depression Scale; Personal Resource Questionnaire; Health and Social Services Utilization Inventory; Kessler - 10. For Caregivers (measures taken at baseline and 12-months except the falls calendar): SF-36 health survey Centre for Epidemiological Studies in Depression Scale SPMSQ; Caregiver Reaction Assessment Scale | ||
Primary | SF-36 Physical Function Score to Measure the Change in Health-related Quality of Life and Function From Baseline (Pre-randomization)to 12 Months. | Baseline (pre-randomization) and 12 months | No |
Secondary | Stroke Impact Scale - 16 | Baseline (pre-randomization) and 12 months | No |
Secondary | Reintegration to Normal Living Index | Baseline (pre-randomization) and 12 months | No |
Secondary | Short Portable Mental Status Questionnaire. | Baseline (pre-randomization) and 12 months | No |
Secondary | Centre for Epidemiological Studies in Depression Scale (CES-D) | 10 minutes | No |
Secondary | Caregiver Reaction Assessment Scale. | Baseline (pre-randomization) and 12 months | No |
Secondary | Personal Resource Questionnaire (PRQ85-Part Two) | Baseline (pre-randomization) and 12 months | No |
Secondary | Health and Social Services Utilization Inventory | Baseline (pre-randomization) and 12 months | No |
Secondary | Kessler - 10 | Baseline (pre-randomization) and 12 months | No |
Sponsors
View Trial Locations
Recruitment
- Enrollment: 101
- Gender: Both
- Minimum Age: N/A
- Accepts Healthy Volunteers: No
- 1 location, 1 country
Principal Investigator
- Maureen Markle-Reid, RN MScN PhD
McMaster University - School of Nursing