A Causal Relationship of Home Care Services on the Quality of Life among Survivors of Stroke in Thailand

Patoomthip  ADUNWATANASIRI; Siriorn  SINDHU; Napaporn  WANITKUN; Chukiat  VIWATWONGKASEM

doi:10.48048/wjst.2021.9049

Authors

Patoomthip ADUNWATANASIRI Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
Siriorn SINDHU Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
Napaporn WANITKUN Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
Chukiat VIWATWONGKASEM Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand

DOI:

https://doi.org/10.48048/wjst.2021.9049

Keywords:

Home care services, Stroke, Self-management, Quality of life

Abstract

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

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References

World Health Organization. The global burden of disease: 2004 update, Available at: https://www.who.int/healthinfo, accessed July 2016.

BM Demaerschalk, HM Hwang and G Leung. US cost burden of ischemic stroke: A systematic literature review. Am. J. Manag. Care 2010; 16, 525-33.

C McKevitt, N Fudge, J Redfern, A Sheldenkar, S Crichton, AR Rudd, A Forster, J Young, I Nazareth, LE Silver, PM Rothwell and CD Wolf. Self-reported long-term needs after stroke. Stroke 2011; 42, 1398-403.

JI Cameron, C Tsoi and A Marsella. Optimizing stroke systems of care by enhancing transitions across care environments. Stroke 2008; 39, 2637-43.

YC Wang, F Yang, H Shi, CM Yang and H Hu. What type of transitional care effectively reduced mortality and improved ADL of stroke patients? A meta-analysis. Int. J. Environ. Res. Public. Health 2017; 14, 510.

CL Lai, MM Tsai, JY Luo, WC Liao, PS Hsu and HY Chen. Post-acute care for stroke: A retrospective cohort study in Taiwan. Patient. Prefer. Adherence 2017; 11, 1309-15.

A Riewpaiboon, W Riewpaiboon, K Ponsoongnern and BV den Berg. Economic valuation of informal care in Asia: A case study of care for disabled stroke survivors in Thailand. Soc. Sci. Med. 2009; 69, 648-53.

S Muengtaweepongsa, P Dharmasaroja and U Kummark. Outcomes of intravenous thrombolytic therapy for acute ischemic stroke with an integrated acute stroke referral network: Initial experience of a community-based hospital in a developing country. J. Stroke Cerebrovasc. Dis. 2012; 21, 42-6.

MB Buntin, CH Colla, P Deb, N Sood and JJ Escarce. Medicare spending and outcomes after post-acute care for stroke and hip fracture. Med. Care 2010; 48, 776-84.

Strategy and Planning Division, Ministry of Public Health. The report on public health resources, Available at: http://bps.moph.go.th, accessed February 2020.

H Wang, ME Sandel, J Terdiman, MA Armstrong, A Klatsky, M Camicia and S Sidney. Postacute care and ischemic stroke mortality: Findings from an integrated health care system in Northern California. J. Inj. Funct. Rehabil. 2011; 3, 686-94.

S Dewilde, L Annemans, A Peeters, D Hemelsoet, Y Vandermeeren, P Desfontaines, R Brouns, G Vanhooren, P Cras, B Michielsens, P Redondo and V Thijs. The relationship between home-time, quality of life and costs after ischemic stroke: The impact of the need for mobility aids, home and car modifications on Home-time. Disabil. Rehabil. 2020; 42, 419-25.

G Warner, T Packer, M Villeneuve, A Audulv and J Versnel. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: Self-management programs for stroke survivors. Disabil. Rehabil. 2015; 37, 2141-63.

JM Cramm and AP Nieboer. The relationship between self-management abilities, quality of chronic care delivery, and wellbeing among patients with chronic obstructive pulmonary disease in The Netherlands. Int. J. Chron. Obstruct. Pulmon. Dis. 2013; 8, 209-14.

WE Haley, DL Roth, B Kissela, M Perkins and G Howard. Quality of life after stroke: A prospective longitudinal study. Qual. Life. Res. 2011; 20, 799-806.

T Tse, SZ Binte Yusoff, L Churilov, H Ma, S Davis, GA Donnan and LM Carey. Increased work and social engagement is associated with increased stroke specific quality of life in stroke survivors at 3 months and 12 months post-stroke: A longitudinal study of an Australian stroke cohort. Top. Stroke Rehabil. 2017; 24, 405-14.

K Sayuri and K Masako. Evaluation of health-related quality of life associated with provision of healthcare to stroke patients living at home in Japan. Health 2015; 7, 1105-13.

L Chen, JW Sit and X Shen. Quasi-experimental evaluation of a home care model for patients with stroke in China. Disabil. Rehabil. 2016; 38, 2271-6.

JF Hair, WC Black, BJ Babin and RE Anderson. Multivariate data analysis. Pearson, New Jersey, 2010, p. 642-91.

A Bierrenbach. Steps in applying Probability Proportional to Size (PPS) and calculating basic probability weights, Available at: https://www.who.int/advisory_bodies, accessed April 2016.

C Simon, S Kumar and T Kendrick. Formal support of stroke survivors and their informal carers in the community: A cohort study. Health Soc. Care Commun. 2008; 16, 582-92.

HC Huang, YC Huang, MF Lin, WH Hou, ML Shyu, HY Chiu and HJ Chang. Effects of home-based supportive care on improvements in physical function and depressive symptoms in patients with stroke: A meta-analysis. Arch. Phys. Med. Rehabil. 2017; 98, 1666-77.

RE Glasgow, EH Wagner, J Schaefer, LD Mahoney, RJ Reid and SM Greene. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med. Care 2005; 43, 436-44.

EM Boger, M Hankins, SH Demain and SM Latter. Development and psychometric evaluation of a new patient-reported outcome measure for stroke self-management: The Southampton Stroke Self - Management Questionnaire (SSSMQ). Health Qual. Life. Outcomes 2015; 13, 165.

MW Post, H Boosman, MM van Zandvoort, PE Passier, GJ Rinke and JM Visser-Meily. Development and validation of a short version of the Stroke Specific Quality of Life scale. J. Neurol. Neurosurg. Psychiatr. 2011; 82, 283-6.

D Hopper, J Coughlan and MR Mullen. Structural equation modeling: Guidelines for determining model fit. Elecron. J. Bus. Res. Meth. 2008; 6, 53-60.

ME Sobel. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol. Methodol. 1982; 13, 290-312.

HF Chen, CY Wu, KC Lin, MW Li and HW Yu. Validity, reliability and responsiveness of a short version of the Stroke-Specific Quality of Life scale in patients receiving rehabilitation. J. Rehabil. Med. 2012; 44, 629-36.

SG Pedersen, GA Heiberg, JF Nielsen, O Friborg, HH Stabel, A Anke and C Arntzen. Validity, reliability and Norwegian adaptation of the Stroke-Specific Quality of Life (SS-QOL) scale. SAGE Open Med. 2018; 6, 1-10.

K Sayuri and K Masako. Evaluation of health-related quality of life associated with provision of healthcare to stroke patients living at home in Japan. Health 2015; 7, 1105-13.

G Musekamp, J Bengel, M Schuler and H Faller. Improved self-management skills predict improvements in quality of life and depression in patients with chronic disorders. Patient Educ. Couns. 2016; 99, 1355-61.

R Reynolds, S Dennis, I Hasan, J Slewa, W Chen, D Tian, S Bobba and N Zwar. A systematic review of chronic disease management interventions in primary care. BMC Fam. Pract. 2018; 19, 11.

CE Fryer, JA Luker, MN McDonnell and SL Hillier. Self management programmes for quality of life in people with stroke. Cochrane Database Syst. Rev. 2016; 2016, CD010442.

LW Green and M Kreuter. Health program planning: An educational and ecological approach. McGraw-Hill, New York, 2005.

J Schmittdiel, DM Mosen, RE Glasgow, J Hibbard, C Remmers and J Bellows. Patient Assessment of Chronic Illness Care (PACIC) and improved patient-centered outcomes for chronic conditions. J. Gen. Intern. Med. 2008; 23, 77-80.

T Deen, T Terna, E Kim, B Leahy and W Fedder. The impact of stroke nurse navigation on patient compliance postdischarge. Rehabil. Nurs. 2018; 43, 65-72.

F Donald, K Kilpatrick, K Reid, N Carter, D Bryant-Lukosius, R Martin-Misener, S Kaasalainen, P Harbman, D Marshall and A DiCenso. Hospital to community transitional care by nurse practitioners: A systematic review of cost-effectiveness. Int. J. Nurs. Stud. 2015; 52, 436-51.

AM Hamza, N Al-Sadat, L Siew Yim and NK Jahan. Predictors of poststroke health-related quality of life in Nigerian stroke survivors: A 1-year follow-up study. Biomed. Res. Int. 2014; 2014, 350281.

C Wanaratwichit, D Hills and M Cruickshank. Home-based care for people with disabilities: Role of registered nurses within the district health system in Thailand. Collegian 2020; 27, 18-22.

BA Pramesona and S Taneepanichskul. Factors influencing the quality of life among Indonesian elderly: A nursing home-based cross-sectional survey. J. Health Res. 2018; 32, 326-33.

DM Pindus, R Mullis, L Lim, I Wellwood, AV Rundell, NA Abd Aziz and J Mant. Stroke survivors’ and informal caregivers’ experiences of primary care and community healthcare services: A systematic review and meta-ethnography. PloS One 2018; 13, e0192533.

J White, P Magin, J Attia, J Sturm, PM Elduff and G Carter. Predictors of health-related quality of life in community-dwelling stroke survivors: A cohort study. Fam. Pract. 2016; 33, 382-7.

PKB Mahesh, MW Gunathunga, S Jayasinghe, SM Arnold and SN Liyanage. Factors influencing pre-stroke and post-stroke quality of life among stroke survivors in a lower middle-income country. Neurol. Sci. 2018; 39, 287-95.