Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand; Department of Nursing, Hasan Sadikin Hospital, Bandung, Indonesia.
Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand.
World Neurosurg. 2024 Apr;184:191-201. doi: 10.1016/j.wneu.2024.01.078. Epub 2024 Jan 19.
Caring for patients with traumatic brain injury (TBI) during the transition from hospital to home can be psychologically challenging to caregivers. This study aimed to assess the effectiveness of a novel mobile health (m-health) transitional care intervention to reduce stress and burden of caregivers of patients with TBI and to reduce readmissions.
A randomized controlled trial was conducted with 74 caregivers of adult patients with moderate or severe TBI admitted to a referral hospital in Indonesia. An m-health application for Android mobile phones was designed including education and information for caregivers. The application included an online chat feature with weekly monitoring. The m-health transitional care intervention also included face-to-face education before hospital discharge. Primary outcomes were caregivers' stress and burden. Outcomes were measured at 3 time points: at hospital discharge, 2 weeks postdischarge, and 4 weeks postdischarge. Random Allocation Software was used for randomization of study participants.
Final analysis included data of 37 caregivers in the intervention group and 37 caregivers in the control group. Stress within the intervention group decreased over time (P < 0.001, mean difference = 11.05). Between both groups, stress was significantly different at 2 weeks and 4 weeks postdischarge (P < 0.001). Caregiver burden showed similar results (2 weeks postdischarge P < 0.001 and 4 weeks postdischarge P < 0.001). Only 1 patient in the control group was readmitted to the hospital.
The m-health transitional care intervention reduced stress and burden of caregivers of patients with moderate or severe TBI. Nurses should consider using m-health technologies to support caregivers in the transition from the hospital into the community.
照顾创伤性脑损伤（TBI）患者从医院过渡到家庭可能会对照顾者的心理造成挑战。本研究旨在评估一种新的移动医疗（m-health）过渡性护理干预措施，以减轻 TBI 患者照顾者的压力和负担，并减少再入院率。
对印度尼西亚一家转诊医院收治的 74 名中度或重度 TBI 成年患者的照顾者进行了一项随机对照试验。为 Android 手机设计了一个 m-health 应用程序，其中包括对照顾者的教育和信息。该应用程序包括带有每周监测的在线聊天功能。m-health 过渡性护理干预还包括在出院前进行面对面的教育。主要结局是照顾者的压力和负担。在 3 个时间点测量结果：出院时、出院后 2 周和出院后 4 周。使用随机分配软件对研究参与者进行随机分组。
最终分析纳入了干预组 37 名和对照组 37 名照顾者的数据。干预组的压力随时间推移而降低（P < 0.001，平均差异为 11.05）。两组之间，出院后 2 周和 4 周时压力差异显著（P < 0.001）。照顾者负担也有类似的结果（出院后 2 周 P < 0.001，出院后 4 周 P < 0.001）。对照组只有 1 名患者再次住院。
m-health 过渡性护理干预减轻了中度或重度 TBI 患者照顾者的压力和负担。护士应考虑使用 m-health 技术在患者从医院过渡到社区时为照顾者提供支持。
