Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study

ABSTRACT Background Care transitions from hospital to home are a critical period for patients and their families, especially after a stroke. The aim of this study was to assess the feasibility, fidelity and acceptability of a co‐designed care transition support for stroke survivors. Methods A non‐ra...

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Main Authors: Sebastian Lindblom, Maria Flink, Lena vonKoch, Ann Charlotte Laska, Charlotte Ytterberg
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Health Expectations
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Online Access:https://doi.org/10.1111/hex.70057
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author Sebastian Lindblom
Maria Flink
Lena vonKoch
Ann Charlotte Laska
Charlotte Ytterberg
author_facet Sebastian Lindblom
Maria Flink
Lena vonKoch
Ann Charlotte Laska
Charlotte Ytterberg
author_sort Sebastian Lindblom
collection DOAJ
description ABSTRACT Background Care transitions from hospital to home are a critical period for patients and their families, especially after a stroke. The aim of this study was to assess the feasibility, fidelity and acceptability of a co‐designed care transition support for stroke survivors. Methods A non‐randomised controlled feasibility study recruiting patients who had had stroke and who were to be discharged home and referred to a neurorehabilitation team in primary healthcare was conducted. Data on the feasibility of recruitment and fidelity of the intervention were collected continuously during the study with screening lists and checklists. Data on the perceived quality of care transition were collected at 1‐week post‐discharge with the Care Transition Measure. Data on participant characteristics, disease‐related data and outcomes were collected at baseline (hospitalisation), 1 week and 3 months post‐discharge. Data on the acceptability of the intervention from the perspective of healthcare professionals were collected at 3 months using the Normalisation Measure Development Questionnaire. Results Altogether, 49 stroke survivors were included in the study: 28 in the intervention group and 21 in the control group. The recruitment and data collection of patient characteristics, disease‐related data, functioning and outcomes were feasible. The fidelity of the intervention differed in relation to the different components of the co‐designed care transition support. The intervention was acceptable from the perspective of healthcare professionals. Concerns were raised about the fidelity of the intervention. A positive direction of effects of the intervention on the perceived quality of the care transition was found. Conclusion The study design, data collection, procedures and intervention were deemed feasible and acceptable. Modifications are needed to improve intervention fidelity by supporting healthcare professionals to apply the intervention. The feasibility study showed a positive direction of effect on perceived quality with the care transition, but a large‐scale trial is needed to determine its effectiveness. Patient or Public Contribution Stroke survivors, significant others and healthcare professionals were involved in a co‐design process, including the joint development of the intervention's components, contextual factors to consider, participant needs and important outcomes to target. Trial Registration ClinicalTrials.gov ID: NCT0292587.
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spelling doaj-art-e09cceea10ad49168504439c02cae25d2025-08-20T02:11:28ZengWileyHealth Expectations1369-65131369-76252024-10-01275n/an/a10.1111/hex.70057Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled StudySebastian Lindblom0Maria Flink1Lena vonKoch2Ann Charlotte Laska3Charlotte Ytterberg4Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm SwedenDepartment of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm SwedenDepartment of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm SwedenDepartment of Clinical Sciences, Danderyd Hospital Karolinska Institutet Stockholm SwedenDepartment of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm SwedenABSTRACT Background Care transitions from hospital to home are a critical period for patients and their families, especially after a stroke. The aim of this study was to assess the feasibility, fidelity and acceptability of a co‐designed care transition support for stroke survivors. Methods A non‐randomised controlled feasibility study recruiting patients who had had stroke and who were to be discharged home and referred to a neurorehabilitation team in primary healthcare was conducted. Data on the feasibility of recruitment and fidelity of the intervention were collected continuously during the study with screening lists and checklists. Data on the perceived quality of care transition were collected at 1‐week post‐discharge with the Care Transition Measure. Data on participant characteristics, disease‐related data and outcomes were collected at baseline (hospitalisation), 1 week and 3 months post‐discharge. Data on the acceptability of the intervention from the perspective of healthcare professionals were collected at 3 months using the Normalisation Measure Development Questionnaire. Results Altogether, 49 stroke survivors were included in the study: 28 in the intervention group and 21 in the control group. The recruitment and data collection of patient characteristics, disease‐related data, functioning and outcomes were feasible. The fidelity of the intervention differed in relation to the different components of the co‐designed care transition support. The intervention was acceptable from the perspective of healthcare professionals. Concerns were raised about the fidelity of the intervention. A positive direction of effects of the intervention on the perceived quality of the care transition was found. Conclusion The study design, data collection, procedures and intervention were deemed feasible and acceptable. Modifications are needed to improve intervention fidelity by supporting healthcare professionals to apply the intervention. The feasibility study showed a positive direction of effect on perceived quality with the care transition, but a large‐scale trial is needed to determine its effectiveness. Patient or Public Contribution Stroke survivors, significant others and healthcare professionals were involved in a co‐design process, including the joint development of the intervention's components, contextual factors to consider, participant needs and important outcomes to target. Trial Registration ClinicalTrials.gov ID: NCT0292587.https://doi.org/10.1111/hex.70057coordinationhandoversintegrated carepatient dischargeperson‐centred carerehabilitation
spellingShingle Sebastian Lindblom
Maria Flink
Lena vonKoch
Ann Charlotte Laska
Charlotte Ytterberg
Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
Health Expectations
coordination
handovers
integrated care
patient discharge
person‐centred care
rehabilitation
title Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
title_full Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
title_fullStr Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
title_full_unstemmed Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
title_short Feasibility, Fidelity and Acceptability of a Person‐Centred Care Transition Support Intervention for Stroke Survivors: A Non‐Randomised Controlled Study
title_sort feasibility fidelity and acceptability of a person centred care transition support intervention for stroke survivors a non randomised controlled study
topic coordination
handovers
integrated care
patient discharge
person‐centred care
rehabilitation
url https://doi.org/10.1111/hex.70057
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