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照顾者可及性和培训与卒中后患者社区出院的关联

Association of Caregiver Availability and Training With Patient Community Discharge After Stroke.

作者信息

Bosch Pamela R, Barr Dawn, Roy Indrakshi, Fabricant Maximillian, Mann Audrey, Mangone Elizabeth, Karmarkar Amol, Kumar Amit

机构信息

Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ.

University of Arizona College of Medicine - Phoenix, Phoenix, AZ.

出版信息

Arch Rehabil Res Clin Transl. 2022 Dec 17;5(1):100251. doi: 10.1016/j.arrct.2022.100251. eCollection 2023 Mar.

Abstract

OBJECTIVE

To examine the association between committed caregivers and caregiver training with community discharge from inpatient rehabilitation after a stroke.

DESIGN

Secondary analysis of data extracted from electronic health records linked with the Uniform Data System for Medical Rehabilitation.

SETTING

Three hospital-based inpatient rehabilitation facilities (IRF) in a major metropolitan area.

PARTICIPANTS

1397 adult patients (mean ± SD age: 69.4 [13.5]; 724 men) transferred from an acute care setting to inpatient rehabilitation after an ischemic or hemorrhagic stroke (N=1397).

INTERVENTION

None.

MAIN OUTCOME MEASURE

Community discharge from IRF.

RESULTS

82.4% of patients had caregivers, 63.4% of patient caregivers received training at the IRF, and 79.5% had community discharge. After adjusting for age, stroke severity, functional status, and other social risk factors, having a committed caregiver and caregiver training were significantly associated with community discharge (odds ratio [OR]=7.80, 95% confidence interval [CI]: 5.03-12.10 and OR=4.89, 95% CI: 3.16-7.57, respectively).

CONCLUSION

Caregivers increase a patient's likelihood of discharge from IRF; the added benefit of caregiver training needs to be further assessed, with essential elements prioritized prior to patients' IRF discharge.

摘要

目的

探讨专职照料者及照料者培训与中风后从住院康复机构社区出院之间的关联。

设计

对从与医学康复统一数据系统相关联的电子健康记录中提取的数据进行二次分析。

地点

一个大城市的三家医院住院康复机构。

参与者

1397名成年患者(平均年龄±标准差:69.4 [13.5];724名男性),在缺血性或出血性中风后从急症护理机构转入住院康复(N = 1397)。

干预措施

无。

主要结局指标

从住院康复机构社区出院。

结果

82.4%的患者有照料者,63.4%的患者照料者在住院康复机构接受了培训,79.5%的患者实现社区出院。在调整年龄、中风严重程度、功能状态及其他社会风险因素后,有专职照料者及照料者培训与社区出院显著相关(优势比[OR]=7.80,95%置信区间[CI]:5.03 - 12.10;OR = 4.89,95% CI:3.16 - 7.57)。

结论

照料者增加了患者从住院康复机构出院的可能性;照料者培训的额外益处需要进一步评估,在患者从住院康复机构出院前应优先考虑关键要素。

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