Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Measurement
Stroke
Oral Presentation
Michelle Camicia, PhD MSN CRRN CCM NEA-BC FAHA
Director, Kaiser Foundation Rehabilitation Center
Kaiser Permanente Vallejo Medical Center
Vallejo, California
Barbara Lutz, PhD, RN, CRRN, PHNA-BC, FAHA, FNAP, FAAN
McNeill Distinguished Professor
University of North Carolina-Wilmington
Wilmington, North Carolina
Brian Theodore, PhD
Research Scientist II
Kaiser Permanente, Kaiser Foundation Rehabilitation Center
Vallejo, California
We review findings from a longitudinal survey of a convenience sample of 184 caregivers (CG) and stroke survivors (SS) served in inpatient rehabilitation. We used the Preparedness Assessment for the Transition Home after Stroke (PATH-s), an tool to assess caregiver preparedness and provide actionable data for treatment planning at discharge and followed the CG/SS for 3 months.The PATH-s predicted PROMIS Global at baseline, 30 day follow up and 90 day follow up. At 90 days, higher scores on the PATH-s was a significant predictor for improvements in activation & caregiving-related HRQOL. Among SS, higher PATH-s scores trended towards reduced readmissions at 90 days, though not reaching significance. However, higher PATH-s scores did predict SS’s better preparedness for discharge.
Objective:
The Preparedness Assessment for the Transition Home after Stroke (PATH-s) was developed to assess caregiver preparedness and provide actionable data for treatment planning. This is a follow-up study on the convergent and predictive validity of the PATH-s.
Design:
Longitudinal survey of a convenience sample of caregivers (CG) and stroke survivors (SS). PATH-s was assessed prior to discharge and evaluated as the predictor.
Setting : Inpatient Rehabilitation Facility (IRF) within an integrated healthcare system.
Participants (or Animals, Specimens, Cadavers) : 184 pairs of stroke survivors (SS) and their caregivers (CG).
Interventions : None.
Main Outcome Measure(s) : Primary outcome for CG was the PROMIS Global health-related quality of life (HRQOL), while secondary outcomes included depression, stress, activation, and caregiving-related HRQOL, all assessed prior to discharge (T1), 30 days (T2) and 90-days (T3) post-discharge. For SS primary outcome was hospital readmissions at T3, secondary outcomes included function and retrospective self-assessment on preparedness for discharge.
Results : The PATH-s predicted PROMIS Global at T1 (partial r = 0.46, p < .01) and T2 (r = 0.31, p < .01). At T3, higher scores on the PATH-s was a significant predictor for improvements in activation (r = 0.24, p < .01) & caregiving-related HRQOL (r = -0.27, p < .05). Among SS, higher PATH-s scores trended towards reduced readmissions at T3, though not reaching significance. However, higher PATH-s scores did predict SS’s better preparedness for discharge.
Conclusions : These findings have implications for implementation as a critical tool for IRF discharge planning. The ability to screen for CG preparedness and intervene in a timely and appropriate manner has significant potential for improving the health and well-being of CG that in turn will promote improved transition for the SS.