Evaluation Of Post-hospital Rehabilitation Services For Stroke-disabled Patients Based On APP Management In A County Of Chongqing

Objective: The aims of our study were to create a stroke rehabilitation service implemented by a nurse-family caregiver,to explore the effect of the RCOVER model on the physical function recovery of the stroke patients with disability in rural areas,and to provide a basis for the intervention of family rehabilitation services for stroke.Methods: 61 patients with cerebral apoplexy and physical function disability were recruited from the Department of Neurology and Department of neurosurgery in a People's Hospital of Chongqing from January 2016 to June,they were randomly divided into the control group(30 cases)and the intervention group(31 cases)using the mobile APP and the central processor random module.In-hospital interventions and the follow-ups were conducted by nurses using the APP.The control group received routine nursing treatment,while the intervention group received RECOVER mode rehabilitation service.Interventions included training and data dissemination of caregivers' rehabilitation skills during hospitalization and before discharge,as well as the follow-up at 2,4 and 8 weeks.The BI index,the improved RANKIN scale(m RS)and the functional walking capacity scale(FAC)of the patients with stroke at the baseline and the discharge were collected by nurse using the APP,and the information about the patient's state of health,the Barthel(BI)index,the modified RANKINscale(m RS),functional walk classification(FAC),hospitalization status,and drug use were collected at 3 months after the discharge,Furthermore,At 6 months,not only 3 months' assessment,but also the European five dimensional health scale(EQ-5D),the patient's Health Questionnaire(9),and the caregiver's burden(CBI)were collected.Descriptive analysis,rank sum test,repeated measurement variance analysis,t test were conducted with SAS 9.1.qualitative data were performed with rate and composition ratio,while,quantitative data were performed with mean±standard deviation,P< 0.05 was considered as statistical difference.Results: No significant differences were observed in the BI index score,m RS score,FAC score between intervention group and control group before discharge(P>0.05).The BI index and its scores of 3 months and 6months after the intervention in intervention group were higher than that in control group,but with no statistical significance(P>0.05).m RS and FAC scores were higher in intervention group than in control group at the 3 and6 month after the discharge,but with no statistical difference(P>0.05).Self repeated measurement of variance analysis suggested that the BI index,the score of each dimension,the m RS score,and the FAC score in both two groups were statistically improved with the time increased(P<0.05).BI index and the score of the dimensions in intervention group were statistically higher at the 3 and 6 month after the discharge compared with the in-hospital,and eating scored statistically higher at the 6 month than the3 month after the discharge(P<0.05),but no other differences were observed between 3 and 6 month after the discharge(P>0.05).No significant differences in EQ-5D score,PHQ-9 score,CBI score were observed between intervention group and control group after 6 months of the hospitalization(P>0.05).Conclusion: In rural areas,stroke rehabilitation services performed byfamily caregivers are in line with the current needs of family rehabilitation in rural areas.However,the effect of the services on the improvement of the physiological functions and activities of daily life of the patients with stroke was unclear,and more research are needed in the futher.