The beneficial effects of transitional care for patients with stroke: A meta-analysis

Patient preferences and willingness to pay for transitional care in breast cancer: a discrete choice experiment

PURPOSE

Most chemotherapy reactions occur outside of the hospital; therefore, providing transitional care (TC) to patients is essential. However, patients' preferences for TC remain poorly understood. This study aims to investigate the preferences and willingness to pay for TC among breast cancer patients.

METHODS

Data were collected using a discrete choice experiment from a large general hospital in North China. The study used six attributes to describe the preferences of patients for TC. Conditional logit and mixed logit models were applied to assess patient preferences, estimate willingness to pay, and simulate uptake probabilities across different scenarios.

RESULTS

A total of 261 respondents completed the survey. The study showed that patients strongly preferred a TC to be provided by a specialist doctor and specialist nurse (β = 0.925; p < 0.001) and were willing to pay CNY¥105.381. The service content most preferred was symptom management, psychological care, and rehabilitation guidance (β = 0.286; p < 0.001), and patients were willing to pay CNY¥32.606. The forms of services most preferred were at outpatient clinics (β = 0.239; p < 0.001), and patients were willing to pay CNY¥27.285. Low out-of-pocket expense was preferred by patients (β = - 0.009; p < 0.001). When TC was provided by a specialist doctor and specialist nurse in an outpatient clinic in conjunction with multidimensional care services and out-of-pocket payment of CNY¥20 per visit, the probability of breast cancer patients' participation increased to 91.39%.

CONCLUSION

The results of this study suggest that breast cancer patients have strong preferences for the provider, content, and form of transitional care (TC), as well as for minimizing out-of-pocket costs.

Exploring Experiences and Perceptions of Stroke Survivors in Hospital-To-Home Transition Care: A Qualitative Systematic Review

AIM

To integrate experiences and perceptions about stroke survivors during the transition from hospital-to-home care.

DATA SOURCES

Seven databases, including PubMed, Embase, Cochrane Library, Ovid, Web of Science, EBSCO and MEDLINE, were searched comprehensively from inception to March 2024, including qualitative studies published in English.

DESIGN

A qualitative systematic review.

METHODS

The search followed the Preferred Reporting Items report for Systematic Reviews and Meta-analysis (PRISMA 2020). The included research quality was assessed according to the Critical Appraisal Skills Programme (CASP). Meta-aggregation was used to develop analytical themes. Confidence in the Evidence from the Reviews of Qualitative Research (GRADE-CERQual) framework was applied to the findings.

RESULTS

Fifteen qualitative studies were included, from which 54 findings were extracted. Similar findings were summarised into eight categories, resulting in four synthesised findings: Joy and sadness intertwined, Destruction of sense of self and life, External support and internal motivation, and Emotional longings and practical needs.

CONCLUSION

Stroke can lead to devastating changes in survivors' sense of self and physically. Through external support from family members and healthcare professionals, as well as internal motivation to cope positively, stroke survivors positively accept and adapt to life. Meanwhile they still have high expectations for personal independence and reintegration into society.

IMPACT

The review findings can guide health professionals, survivors and families in optimising care during the hospital-to-home transition.

PROTOCOL REGISTRATION

PROSPERO [CRD42024522555].

REPORTING

ENTREQ. No Patient or Public Contribution.

A scoping review of hospital to home transitional care programmes for stroke survivors

AIM

The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors.

BACKGROUND

Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke.

DESIGN

A scoping review.

METHODS

Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews.

DATA SOURCES

A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net-work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023.

RESULTS

Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full-text screening. Full-text screening yielded 49 articles that met inclusion criteria.

CONCLUSION

This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them.

REPORTING METHOD

PRISMA checklist for scoping reviews.

PATIENT AND PUBLIC CONTRIBUTION

No patient or public contribution was part of this study.

Development of a patient-centered transition program for stroke survivors and their informal caregivers, combining case-management and access to an online information platform: A user-centered design approach

Background

During the hospital-to-home transition, stroke survivors and their caregivers face a significant lack of support and information which impacts their psychosocial recovery. We aimed to co-design a program combining individual support by a trained case-manager (dedicated professional providing individual support) and an online information platform to address needs of stroke survivors and caregivers.

Methods

A two-step methodology was used. The first step followed a "user-centered design" approach during four workshops with stroke survivors, caregivers, and healthcare professionals to develop the platform and define the case-manager profile. The second step was a usability test of the platform following a Think Aloud method with patients and caregivers. The workshops and interviews were analyzed following a qualitative thematic analysis. The analysis of Think Aloud interviews was based on User Experience Honeycomb framework by Morville.

Results

Eight participants attended the workshops: two patients, two caregivers, three nurses, and a general practitioner. Activities, training, and skills of the case-manager were defined according to stroke survivors and caregivers needs. Name, graphics, navigation, and content of the platform were developed with the participants, a developer and a graphic designer. The usability of the platform was tested with 5 patients and 5 caregivers. The Think Aloud confirmed satisfaction with graphics and content but a need for improvement regarding the navigability. An update of the platform was conducted in order to answer the needs expressed by participants.

Conclusion

We developed, with a participatory approach, a patient-centered transition program, which will be evaluated in a randomized controlled trial.