Training and Support Needs in Transitional Care From Hospital to Home of the Health Care Professional-Caregiver-Stroke Survivor Triad: A Meta-Synthesis Study.

INTRODUCTION

Stroke represents the second leading cause of death worldwide after cardiovascular disease and the first cause of disability in adults. Only 25% of stroke survivors fully recover, 75% survive with some form of disability, and half of them lose self-sufficiency, negatively impacting their quality of life. This study aims to understand the experiences of stroke survivors and caregivers of training needs and support during the transitional care phase from hospital to home; it also investigates the experience of health care professionals (HCPs) of providing support and training to the dyad during this phase.

METHODS

Meta-synthesis was conducted following a critical-interpretative approach. The SPIDER method was used for sample selection, and the PRISMA research question was adopted for article selection. The search for studies on CINAHL, Pubmed, Scopus, ERIC, PsycInfo and OVID was conducted until August 2024.

RESULTS

Of the 1123 articles found, 32 met the inclusion criteria and were included in the meta-synthesis. Text analysis revealed two main thematic areas: (1) the training need is a new awareness in the transition of care from hospital to home and (2) moulding oneself to new life. The first theme had six subthemes: need for information and training, uncertainty, involvement, evaluation of training needs, individual discharge planning and physical-psychological problems. The second theme included three subthemes: different role perception, support after discharge and adaptation to change.

CONCLUSIONS

Knowing the training and support needs in the stroke survivor caregiver dyad guides HCPs to structure tailored discharge plans. Multi-method and multidisciplinary training and support interventions such as health coaching, weekend passes and early supported discharge are satisfactory outcomes for the triad involved in the transition of care, as continuous feedback on the needs of the new reality at home fortifies the relationship between the dyad and HCPs. A transitional care pathway based on the dynamic needs of the triad can improve the quality of care in the community.