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一种基于移动应用程序的中风幸存者及其护理人员预防和管理中风后并发症的中风后护理策略——“中风家庭护理”:开发与可行性

A mobile application-based post-stroke care strategy for survivors and their caregivers for prevention and management of post-stroke complications - "Stroke Home Care:" Development and feasibility.

作者信息

Kumar Ashok, Khurana Dheeraj, Pattanaik Smita, Kumar Mukesh, Kaur Sukhpal, Krishnan Narayanan Chatapuram, Ghai Sandhya, Modi Manish, Nagi Manisha, Chellappa Rajan, Gairolla Jitender, Munjal Divesh Kumar, Kumar Pramod

机构信息

National Institute of Nursing Education, Chandigarh, India.

Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Neurosci Rural Pract. 2024 Apr-Jun;15(2):217-226. doi: 10.25259/JNRP_411_2023. Epub 2023 Oct 5.

Abstract

OBJECTIVES

In developing nations such as India, a disparity exists between the available resources for stroke rehabilitation and the substantial burden of stroke cases. Consequently, the provision of cost-effective and multidisciplinary post-stroke rehabilitation care to stroke survivors becomes of paramount importance. The utilization of mobile applications (apps) for stroke care has been on the rise, offering a personalized and pragmatic solution with the potential for wider reach in settings constrained by limited resources. To address the unmet needs in the prevention and management of post-stroke complications, we conceptualized a strategy known as a mobile application-based post-stroke care strategy for both survivors and their caregivers.

MATERIALS AND METHODS

The scope of the app's focus was determined based on the incidence of post-stroke complications within a prospective cohort of stroke patients, in conjunction with existing literature. An initial "web-based mobile app" prototype was crafted to align with the identified focus area. Before the development of the final app version, a feasibility study was conducted involving 30 participant dyads (comprising a patient and a caregiver). Content validity was evaluated by a panel of 20 stroke experts encompassing neurologists, nurses, physiotherapists, and psychologists.

RESULTS

The "Stroke Home Care" (SHC) mobile app was conceived as a web-based educational tool aimed at preventing and managing post-stroke complications. It seeks to train caregivers of immobile stroke patients in the administration of preventive and therapeutic care procedures, thereby potentially enhancing survivors' quality of life and alleviating caregivers' burden. The feasibility and validity studies indicated "high satisfaction" levels among most caregivers and experts (>75%), with the remainder expressing "satisfaction" and no "dissatisfaction" regarding app utilities. Stroke experts unanimously deemed the app "appropriate", with consensus on contents, video quality, video length, and voice clarity. Caregivers reported "satisfactory" user experiences, encountering no issues during app installation or operation. Suggestions from both caregivers and experts were integrated into the final app version.

CONCLUSION

The "SHC" app represents a feasible and well-received innovation tailored for the use by caregivers of stroke survivors. Consequently, the initial feasibility of the developed app serves as a precursor to a randomized controlled clinical trial aimed at substantiating its effectiveness within the post-stroke survivor and caregiver population. Notably, within resource-constrained contexts, this app has the potential to be a pivotal tool for post-stroke care.

摘要

目的

在印度等发展中国家,中风康复可用资源与中风病例的沉重负担之间存在差距。因此,为中风幸存者提供具有成本效益的多学科中风后康复护理至关重要。用于中风护理的移动应用程序(应用)的使用一直在增加,它提供了一种个性化且实用的解决方案,在资源有限的环境中具有更广泛覆盖的潜力。为满足中风后并发症预防和管理方面未得到满足的需求,我们构思了一种策略,即针对幸存者及其护理人员的基于移动应用程序的中风后护理策略。

材料与方法

根据中风患者前瞻性队列中中风后并发症的发生率,并结合现有文献,确定该应用的关注范围。制作了一个初始的“基于网络的移动应用程序”原型,以符合确定的关注领域。在开发最终应用版本之前,进行了一项可行性研究,涉及30个参与者二元组(由一名患者和一名护理人员组成)。由20名中风专家组成的小组对内容效度进行了评估,这些专家包括神经科医生、护士、物理治疗师和心理学家。

结果

“中风家庭护理”(SHC)移动应用程序被构想为一种基于网络的教育工具,旨在预防和管理中风后并发症。它旨在培训行动不便的中风患者的护理人员进行预防和治疗护理程序,从而有可能提高幸存者的生活质量并减轻护理人员的负担。可行性和效度研究表明,大多数护理人员和专家(>75%)的满意度为“高”,其余人员对应用程序的效用表示“满意”且无“不满意”。中风专家一致认为该应用“合适”,在内容、视频质量、视频长度和语音清晰度方面达成共识。护理人员报告了“满意”的用户体验,在应用程序安装或操作过程中未遇到问题。护理人员和专家的建议都被纳入了最终应用版本。

结论

“SHC”应用程序是一项针对中风幸存者护理人员使用的可行且广受好评的创新。因此,所开发应用程序的初步可行性是一项随机对照临床试验的前奏,该试验旨在证实其在中风幸存者和护理人员群体中的有效性。值得注意的是,在资源有限的环境中,该应用程序有可能成为中风后护理的关键工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397c/11090587/b951c0c65bb8/JNRP-15-217-g001.jpg

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