Type of Project: In-house project Study
Care situation, frequency of falls and health-related quality of life in stroke patients in the long-term course after inpatient neurological rehabilitation

How do stroke patients fare in terms of care and health-related quality of life in the long-term after discharge from inpatient neurological rehabilitation? Are there correlations between fall frequency and quality of life? Are there correlations between condition at discharge, further care during the course, mortality and home admission? Are there associations between further medical care and quality of life? Methodology: The prospective cohort study included 260 stroke patients undergoing neurological rehabilitation phases B (early rehabilitation) and C (continuing rehabilitation) in 2006. Study time points to date were the first week after admission to the rehabilitation clinic (T1), the discharge week (T2), and one year (T3) and 2.5 years (T4) after discharge (telephone interviews). Drop-out criteria were defined as: Death, acute transfer, surgical onward transfer, inpatient length of stay less than 14 days, and lack of consent to participate in the study or lack of capacity to give consent. All patients who did not meet drop-out criteria were contacted by telephone one year and 2.5 years after discharge. Contents of the telephone interviews included type of care, health-related quality of life, and fall frequency and resulting fall outcomes. The interviewer was a rehabilitation-specific trained nurse with many years of professional experience in the questions. Initial results: One year after discharge, 230 telephone interviews could be conducted (23 patients met a drop-out criterion, seven additional patients could not be reached). The care situation was characterized by predominantly home-based outpatient care (84%). five percent of respondents received care in a nursing home, and 11% were deceased. Data for 2.5 years after discharge are currently being processed. The health-related quality of life of patients one year after inpatient rehabilitation proved to be significantly more often "moderately" or "extremely" burdened in all dimensions compared to the German population. This was particularly true with regard to problems with general activities (67% vs. 19%) and anxiety and dejection (50% vs. 4%). At ten percent, a comparatively small proportion of patients reported having fallen in the four weeks prior to the telephone interview. It is possible that not every fall event is remembered. The patients who had fallen suffered significantly more from pain than those who had not (p = 0.035) and tended to have more mobilization problems (p = 0.102). The one-year results were presented at the 7th International Conference on Nursing and Nursing Science in Ulm on September 24-25, 2009. Outlook: In 2011, the entire collective is to be surveyed again about the housing and care situation as well as quality of life at intervals of five years after discharge.