Since 2017, Hong Kong has provided post-acute stroke services in clinics operated by stroke advanced practice nurses (APNs). Currently, the applicability of the clinics has been further limited by the emergence of the coronavirus (COVID-19) pandemic due to restrictions on visits to the clinics and tightened social distancing requirements. Telecare consultations may be a viable option for contributing more flexible, interactive, and cost-efficient care models to support stroke survivors over the longer run. The present study takes advantage of this opportunity by utilizing implementation science to simultaneously implement and evaluate a telecare model of care in a nurse-led post-acute stroke clinic.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
196
Using Zoom to communicate with patients
Face-to-face communication with patients
Queen Elizabeth Hospital
Kowloon, Hong Kong
Chang in Degree of disability after stroke
Simplified modified Rankin scale will be used to measure the degree of disability for stroke patients. The scale has three questions to identify whether the patient has a score from 0 to 5, with higher scores representing higher degree of disability.
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Incidence of the recurrence of stroke
The percentage of participants who re-admitted to hospital because of recurrent stroke
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Change of Quality of life, which measures an individual perception oftheir position in life. It includes physical and mental health.
Quality of life will be measured using the Hong Kong version of EuroQol 5-dimension. The scale has five subdomains, which include mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Since the scale has 5 items, each digit in the five digit codes refers to the status of each dimension, ranging from 1 for no problem, to 5 for sever problem. A higher scores indicate better quality of life.
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Change of Post-stroke depression
Post-stroke depression will be measured using the Chinese version of the Geriatric Depression scale. This scale has a minimum score of 0 and a maximum score of 15. Lower scores represent lower depression level.
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Change of Medication adherence
Medication adherence will be determined using the Adherence to Refills and Medications Scale. The scale produces an overall adherence score of 10-40, with lower scores indicating better adherence.
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Change of Social participation
Social participation will be measured using the 11-item Reintegration to Normal Living index. This scale is used to measure whether the patient has participated in several social activities before and after occurrence of stroke. The scale yields total score from 0-22, with higher scores indicating poorer social participation.
Time frame: baseline, three months when the program is completed, three months after the program is completed.
Number of attendances at a general practitioners' office, emergency department, hospital, and general out-patient clinic
To measure the utilization of healthcare services by stroke patient before and after the intervention
Time frame: baseline, three months when the program is completed, three months after the program is completed.
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