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.
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
目的: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。
方法: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。
结果: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。
结论: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。