Johnson Karlon H, Gardener Hannah, Gutierrez Carolina M, Marulanda Erika, Campo-Bustillo Iszet, Gordon-Perue Gillian, Brown Scott C, Ying Hao, Zhou Lili, Bishop Lauri, Veledar Emir, Fakoori Farya, Asdaghi Negar, Koru-Sengul Tulay, Hlaing WayWay M, Romano Jose G, Rundek Tatjana
University of Miami Miller School of Medicine, Miami, FL, USA (KHJ, HG, CMG, EM, IC-B, GG-P, SCB, HY, LZ, LB, EV, FF, NA, TK-S, WMH, JGR, TR).
Am J Lifestyle Med. 2024 Oct 23:15598276241294243. doi: 10.1177/15598276241294243.
This study identifies the association between patient perception of discharge education/resources and adequate transitions of care (ATOC) (i.e., patient achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization). The analysis measured the association between sufficient discharge communication (SDC) (i.e., patient receipt of sufficient diet education, sufficient toxic habit cessation education, if applicable, and scheduled medical follow-up appointment) and ATOC within 30 days post-discharge overall and by race/ethnicity [non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic] in the Transitions of Care Stroke Disparities Study (TCSD-S) (2018-2023). In our sample (N = 1151, Average Age 64+/-14 years, 57% Men, 54% NHW, 24% NHB, 23% Hispanic), 31% overall, as well as 22% of NHW, 43% of NHB, and 41% of Hispanics reported SDC. After covariate adjustment, patients reporting SDC had increased likelihood of accomplishing ATOC when compared to patients not reporting SDC overall (OR = 1.97; 95% CI: 1.42-2.74) and among NHW (OR = 2.76; 95% CI: 1.64-4.64) and NHB (OR = 2.29; 95% CI: 1.16-4.53). The association among Hispanic participants was not statistically significant. Our findings reinforce the importance of providing quality communication to patients to ensure a successful transition of care from hospital to home or rehabilitation facility.
本研究确定了患者对出院教育/资源的认知与充分的护理过渡（ATOC）（即患者在中风住院后30天内实现至少75%的推荐积极行为和活动）之间的关联。该分析测量了充分出院沟通（SDC）（即患者接受充分的饮食教育、充分的有毒习惯戒除教育（如适用）以及定期的医疗随访预约）与出院后30天内总体及按种族/族裔分类的ATOC之间的关联，种族/族裔包括非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔，数据来自护理过渡中风差异研究（TCSD-S）（2018 - 2023年）。在我们的样本中（N = 1151，平均年龄64±14岁，57%为男性，54%为NHW，24%为NHB，23%为西班牙裔），总体上31%的患者、22%的NHW患者、43%的NHB患者和41%的西班牙裔患者报告有SDC。经过协变量调整后，与未报告SDC的患者相比，报告有SDC的患者总体上（OR = 1.97；95% CI：1.42 - 2.74）以及NHW患者（OR = 2.76；95% CI：1.64 - 4.64）和NHB患者（OR = 2.29；95% CI：1.16 - 4.53）实现ATOC的可能性增加。西班牙裔参与者之间的关联无统计学意义。我们的研究结果强化了向患者提供高质量沟通以确保从医院到家庭或康复机构的护理顺利过渡的重要性。
