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Perceived Participation in Discharge Planning and Health Related Quality of Life after Stroke
Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to investigate the patients’ and their relatives’ perceived participation in discharge planning after stroke and the patients’ health-related quality of life, depressive symptoms, performance of personal daily activities and social activities in connection with discharge. Another aim was to evaluate the psychometric assumptions of the SF-36 for Swedish stroke patients.

Prospective, descriptive and cross-sectional designs were used to study all patients with stroke admitted to the stroke unit at a hospital in southern Sweden from October 1, 2003 to November 30, 2005 each with one close relative. The total sample consisted of 188 patients (mean age=74.0 years) and 152 relatives (mean age=60.1 years). Data were collected during interviews, 2-3 weeks after discharge.

The results showed that less depressive symptoms, more outdoor activities and performance of interests are important variables that related to higher HRQoL. SF-36 functions well as a measure of health related quality of life in Swedish stroke patients, but the two summary scales have shortcomings. Compared to a Swedish normal population, scores on all scales/components of the SF-36 were lower among stroke patients especially in the middle-aged group. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal setting. The relatives perceived that they need more information and they perceived low participation in goal setting and needs assessment. The professionals seem to lack effective practices for involving patients and their relatives to perceive participation in discharge planning. It is essential to develop and to implement methods for discharge planning, including sharing information, needs assessment with goal setting that facilitate patients’ and relatives’ perceived participation. The results suggest that ICF can be used in goal setting and needs assessment in discharge planning after acute stroke.

Place, publisher, year, edition, pages
Jönköping: Hälsohögskolan , 2008. , p. 108
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 4
Keywords [en]
Discharge planning, Goal-setting, Health related quality of life, ICF, Information, Needs assessment, Patient participation, Relatives participation, Social activities, Stroke
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-1223ISBN: 978-91-85835-03-4 (print)OAI: oai:DiVA.org:hj-1223DiVA, id: diva2:3673
Public defence
2008-05-16, Forum Humanum, Hälsohögskolan i Jönköping, 10:00 (English)
Opponent
Supervisors
Available from: 2009-01-20 Created: 2008-11-06 Last updated: 2018-01-12Bibliographically approved
List of papers
1.
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2. Discharge planning of stroke patients: The relatives' perceptions of participation
Open this publication in new window or tab >>Discharge planning of stroke patients: The relatives' perceptions of participation
2009 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 857-865Article in journal (Refereed) Published
Identifiers
urn:nbn:se:hj:diva-1438 (URN)10.1111/j.1365-2702.2008.02600.x (DOI)
Available from: 2008-04-28 Created: 2009-04-06 Last updated: 2017-12-12Bibliographically approved
3. Quality of Life among Swedish Patients after Stroke: Psychometric Evaluation of SF-36
Open this publication in new window or tab >>Quality of Life among Swedish Patients after Stroke: Psychometric Evaluation of SF-36
2009 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 1, p. 48-53Article in journal (Refereed) Published
Identifiers
urn:nbn:se:hj:diva-1439 (URN)
Available from: 2008-04-28 Created: 2009-04-06 Last updated: 2017-12-12Bibliographically approved
4. Discharged after stroke - important factors for health-related quality of life.
Open this publication in new window or tab >>Discharged after stroke - important factors for health-related quality of life.
2010 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 15-16, p. 2196-2206Article in journal (Refereed) Published
Abstract [en]

AIMS: This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke.

BACKGROUND: HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge.

DESIGN: Cross-sectional study.

METHODS: The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL.

RESULTS: Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL.

CONCLUSIONS: Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests.

RELEVANCE TO CLINICAL PRACTICE: These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.

National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-24236 (URN)10.1111/j.1365-2702.2010.03251.x (DOI)20659199 (PubMedID)
Available from: 2014-07-09 Created: 2014-07-09 Last updated: 2018-06-26

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Almborg, Ann-Helene

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