ABSTRACT
Background
Few studies have investigated changes in physical function, psychological status,
and quality of life (QOL) among stroke survivors receiving post-acute care (PAC).
Nursing care has an important effect on patient outcomes, but there is very little
evidence of nurses’ role in rehabilitation after stroke in Taiwan.
Aim
To investigate the trajectories of physical function, depressive symptoms, QOL, and
factors associated with QOL in patients who received a hospital-based PAC program
over 12 weeks after stroke.
Methods
A quasi-experimental design was employed and the study conducted in a teaching hospital
in central Taiwan. Measurement tools included the Barthel Index, modified Rankin Scale,
Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, and Stroke
Impact Scale. Data were collected at weeks one, four, eight and twelve after stroke.
Descriptive, inferential, generalized estimating equations, and multiple linear regression
analyses were performed.
Findings
Overall, 61 stroke survivors (mean age, 67.59 ± 15.64 years) were enrolled: 93.44%
of strokes were ischaemic, and 59.02% of participants were male. Forty-one patients
had received hospital-based PAC, while 20 had not. The PAC group exhibited significant
improvements (all p < 0.05) in physical function recovery, depressive symptoms, and QOL from the 8th
week post stroke compared with the regular care group. Functional recovery and depressive
symptoms were significantly associated with QOL at weeks four, eight and twelve weeks
after stroke.
Discussion
The hospital-based PAC program led to improved physical function, depressive symptoms,
and QOL in patients over the 12 weeks following stroke. Physical function and depression
after stroke were factors significantly associated with the patients’ QOL.
Conclusion
Both functional and psychological recovery impact the QOL of stroke survivors. Nurses
are responsible for enhancing stroke survivors’ functional activities, recognising
and supporting their psychological issues, and improving their QOL via interventions
implemented during the PAC rehabilitation program.
Keywords
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Article info
Publication history
Published online: February 28, 2023
Accepted:
January 10,
2023
Received in revised form:
January 7,
2023
Received:
September 13,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd on behalf of Australian College of Nursing Ltd.
