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满足小中风后未满足的需求:SUN 随机对照试验方案。

Meeting unmet needs following minor stroke: the SUN randomised controlled trial protocol.

机构信息

School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.

Speech Pathology Department, Princess Alexandra Hospital, Brisbane, Australia.

出版信息

BMC Health Serv Res. 2019 Nov 27;19(1):894. doi: 10.1186/s12913-019-4746-1.

Abstract

BACKGROUND

Whilst there are comprehensive guidelines for the rehabilitation of people with severe impairments from stroke, there has been less attention on the health and rehabilitation needs of people with minor stroke. Our study will assess whether a new multi-component service pathway using an integrated model based around primary care will reduce unmet need following minor stroke compared with usual care 1 and 3 months post-hospital discharge.

METHODS

One hundred ten patients with minor stroke will be recruited within a parallel, randomised controlled trial design comparing a new service pathway and usual care. The new service pathway will comprise a self-management kit, customised General Practitioner checklist, and a series of minor stroke educational topics. Participants will complete assessments pre-hospital discharge and 1 and 3 months later. The primary outcome measure will be the Survey of Unmet Needs and Service Usage. Secondary outcome measures will include assessments of ability, adjustment and participation; social group connectedness; return to work; health-related quality of life; and perceptions of the new service pathway (intervention group only). Mixed model repeated measures will be used to analyse within and between group differences at each time point. Return to work will be analysed using Chi square tests. Perceptions of the new service pathway will be analysed qualitatively.

DISSEMINATION OF RESULTS

The project will produce an evidence-based, multicomponent service pathway for minor stroke patients, applicable to other health services nationally and internationally. Dissemination will include publications and presentations.

TRIAL REGISTRATION

Prospectively registered - Australian New Zealand Clinical Trials Registry (ACTRN12619000133134p) 30 January 2019.

摘要

背景

虽然有针对严重中风患者康复的全面指南,但对轻度中风患者的健康和康复需求关注较少。我们的研究将评估一种新的多组件服务途径,该途径使用基于初级保健的综合模式,与常规护理相比,在轻度中风后 1 和 3 个月,是否会减少未满足的需求。

方法

采用平行随机对照试验设计,比较新的服务途径和常规护理,招募 110 名轻度中风患者。新的服务途径将包括自我管理工具包、定制的全科医生检查表和一系列轻度中风教育主题。参与者将在出院前和出院后 1 个月和 3 个月进行评估。主要结局指标是未满足需求和服务使用调查。次要结局指标包括能力、调整和参与评估;社会群体联系;重返工作岗位;健康相关生活质量;以及对新服务途径的看法(仅干预组)。将使用混合模型重复测量分析每个时间点的组内和组间差异。将使用卡方检验分析重返工作岗位的情况。将对新服务途径的看法进行定性分析。

结果的传播

该项目将为轻度中风患者提供循证、多组件的服务途径,适用于国内外其他卫生服务。传播将包括出版物和演讲。

试验注册

前瞻性注册 - 澳大利亚新西兰临床试验注册中心(ACTRN12619000133134p),2019 年 1 月 30 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cbe/6880549/4702f582ab69/12913_2019_4746_Fig1_HTML.jpg

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