背景:卒中影响卒中幸存者及其家人生活的许多方面,出院后回家是病人及其亲属的关键一步。患者和护理人员报告在此过渡期间对建议和信息的大量需求。我们的假设是,通过全面、为患者及其护理人员提供个性化和灵活的支持,以患者为中心的中风后医院/家庭过渡计划,结合互联网信息平台和案件经理的电话跟进,可以提高患者的参与水平和生活质量。
方法:一项开放的平行组随机试验将在法国的两个中心进行。我们将招募170名首次确诊中风的成年患者,并从卒中单元直接出院,修改后的Rankin评分≤3。干预内容将使用以用户为中心的方法定义,涉及患者,看护者,卫生保健专业人员和社会工作者。随机分配到干预组的患者将在回国后的12个月内接受训练有素的病例管理器的电话支持,并访问交互式互联网信息平台。随机分配到对照组的患者将接受常规护理。主要结果是患者参与,出院后6个月,通过卒中影响量表的“参与”维度得分进行测量。次要结果将包括,对于患者来说,生活质量,激活,护理消费,除了身体,心理和社会结果;对于照顾者,生活质量和负担。患者将在出院后一周内联系,在6个月和12个月的结果收集。计划与研究一起进行过程评估。
结论:我们以患者为中心的计划将赋予患者及其看护者权力,通过个性化和渐进的后续行动,在可用的医疗保健和社会服务范围内找到自己的方式,更好地理解它们并更有效地使用它们。集中病例管理员通过电话和在线平台的行动将使这种干预措施传播给大量患者成为可能,在广阔的区域,甚至在地理隔离的情况下。
背景:临床试验NCT03956160,发布时间:2019年5月和更新时间:2021年9月。
BACKGROUND: Stroke affects many aspects of life in stroke survivors and their family, and returning home after hospital discharge is a key step for the patient and his or her relatives. Patients and caregivers report a significant need for advice and information during this transition period. Our hypothesis is that, through a comprehensive, individualised and flexible support for patients and their caregivers, a patient-centred post-stroke hospital/home transition programme, combining an Internet information platform and telephone follow-up by a
case manager, could improve patients\' level of participation and quality of life.
METHODS: An open parallel-group randomized trial will be conducted in two centres in France. We will recruit 170 adult patients who have had a first confirmed stroke, and were directly discharged home from the stroke unit with a modified Rankin score ≤3. Intervention content will be defined using a user-centred approach involving patients, caregivers, health-care professionals and social workers. Patients randomized to the intervention group will receive telephonic support by a trained
case manager and access to an interactive Internet information platform during the 12 months following their return home. Patients randomized to the control group will receive usual care. The primary outcome is patient participation, measured by the \"participation\" dimension score of the Stroke Impact Scale 6 months after discharge. Secondary outcomes will include, for patients, quality of life, activation, care consumption, as well as physical, mental and social outcomes; and for caregivers, quality of life and burden. Patients will be contacted within one week after discharge, at 6 and 12 months for the outcomes collection. A process evaluation alongside the study is planned.
CONCLUSIONS: Our patient-centred programme will empower patients and their carers, through individualised and progressive follow-up, to find their way around the range of available healthcare and social services, to better understand them and to use them more effectively. The action of a centralised
case manager by telephone and the online platform will make it possible to disseminate this intervention to a large number of patients, over a wide area and even in cases of geographical isolation.
BACKGROUND: ClinicalTrials NCT03956160 , Posted: May-2019 and Update: September-2021.