Effect of intermediate care model on the functional outcome and quality of life of older adult stroke survivors in Southwest Nigeria
Temitope Hannah Farombi
College of Nursing, Midwifery and Healthcare
Supervisors:
Professor Hafiz Khan
College of Nursing, Midwifery and Healthcare
Professor Muili Lawal
College of Nursing, Midwifery and Healthcare
Objective:
Significant gaps exist in post-acute care, which make it difficult to prepare elderly stroke patients and their carers for recovery and secondary risk factor management. This study aimed to assess the effectiveness of the intermediate care support provided in improving the functional outcomes of elderly individuals recovering from stroke.
Research question:
How will the intermediate care model improve the functional health and quality of life of older adults with stroke in southwest Nigeria?
Methods:
A prospective longitudinal study was conducted among 58 stroke survivors, within 30 days post discharge from acute care, aged ≥ 60 years and their respective family caregivers. The family caregivers were trained with a developed intermediate care model. A pre-and post-assessment was performed before and eight weeks after the training on the Barthel Index and stroke-specific quality of life of stroke survivors (SSQOL). Data was analysed using descriptive, t-test and Difference-in-difference (DID) analysis.
Main Findings:
The mean age of survivors was 69.10±8.47. The majority of the participants were males (58.6%). All domains included in the SSQOL improved significantly; energy (p<0.001), language (p<0.001), mobility (p<0.001), mood (p<0.001), personality (p=0.014), self-care (p<0.001), social role (p<0.001), thinking (p<0.001), upper extremity function (<0.001), vision (p<0.001), work/productivity (p<0.001). All domains in the Barthel index except bowel continence improved significantly. Overall Barthel index scores showed a statistically significant improvement (p<0.001).
Significance:
This study suggests that the implementation of an intermediate care model at the community/home could improve older adult stroke survivors’ functional outcomes and quality of life. Findings could inform policy changes in the stroke care continuum that could improve overall health outcomes in low-resource settings