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Dyadic approach to post-stroke hospitalizations: role of caregiver and patient characteristics.

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Date
2019-11-04
Authors
Tyagi, Shilpa
Koh, Gerald CH
Luo, Nan
Tan, Kelvin B
Hoenig, Helen
Matchar, David B
Yoong, Joanne
Chan, Angelique
Lee, Kim En
Venketasubramanian, N
Menon, Edward
Chan, Kin Ming
De Silva, Deidre Anne
Yap, Philip
Tan, Boon Yeow
Chew, Effie
Young, Sherry H
Ng, Yee Sien
Tu, Tian Ming
Ang, Yan Hoon
Kong, Keng He
Singh, Rajinder
Merchant, Reshma A
Chang, Hui Meng
Yeo, Tseng Tsai
Ning, Chou
Cheong, Angela
Ng, Yu Li
Tan, Chuen Seng
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(29 total)
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Abstract
AIM:To study the association of caregiver factors and stroke patient factors with rehospitalizations over the first 3 months and subsequent 3-12 months post-stroke in Singapore. METHODS:Patients with stroke and their caregivers were recruited in the Singapore Stroke Study, a prospective yearlong cohort. While caregiver and patient variables were taken from this study, hospitalization data were extracted from the national claims database. We used Poisson modelling to perform bivariate and multivariable analysis with counts of hospitalization as the outcome. RESULTS:Two hundred and fifty-six patient with stroke and caregiver dyads (N = 512) were analysed, with patients having spouse (60%), child (29%), sibling (4%) and other (7%) as their caregivers. Among all participants, 89% of index strokes were ischemic, 57% were mild in severity and more than half (59%) of the patients had moderate or severe disability post-stroke as measured on the Modified Rankin Scale. Having social support in the form of a foreign domestic worker for general help of caregiver reduced the hospitalization rate over 3 months post-stroke by 66% (IRR: 0.342; 95% CI: 0.180, 0.651). Compared to having a spousal caregiver, those with a child caregiver had an almost three times greater rate of hospitalizations over 3-12 months post-stroke (IRR: 2.896; 95% CI: 1.399, 5.992). Higher reported caregiving burden at the 3-month point was associated with the higher subsequent rate of hospitalization. CONCLUSION:Recommendations include the adoption of a dyadic or holistic approach to post-stroke care provision by healthcare practitioners, giving due importance to both patients with stroke and their caregivers, integrating caregivers in the healthcare system to extend the care continuum to include informal care in the community and provision of timely support for caregivers.
Type
Journal article
Subject
Humans
Hospitalization
Prospective Studies
Family
Spouses
Caregivers
Singapore
Stroke
Permalink
https://hdl.handle.net/10161/22776
Published Version (Please cite this version)
10.1186/s12883-019-1510-4
Publication Info
Tyagi, Shilpa; Koh, Gerald CH; Luo, Nan; Tan, Kelvin B; Hoenig, Helen; Matchar, David B; ... Tan, Chuen Seng (2019). Dyadic approach to post-stroke hospitalizations: role of caregiver and patient characteristics. BMC neurology, 19(1). pp. 267. 10.1186/s12883-019-1510-4. Retrieved from https://hdl.handle.net/10161/22776.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Hoenig

Helen Marie Hoenig

Professor of Medicine
1. General Focus and Goals of Research: Dr. Hoenig's research focuses on rehabilitation, and more specifically on assistive technology and teletechnology. Patient populations of interest include geriatric patients with diverse medical problems including stroke, spinal and/or musculoskeletal disorders. 2. Specific Approaches or Techniques: Randomized controlled trials, epidemiological studies including large data base analyses and survey research. Clinical trials include studi
Matchar

David Bruce Matchar

Professor of Medicine
My research relates to clinical practice improvement - from the development of clinical policies to their implementation in real world clinical settings. Most recently my major content focus has been cerebrovascular disease. Other major clinical areas in which I work include the range of disabling neurological conditions, cardiovascular disease, and cancer prevention. Notable features of my work are: (1) reliance on analytic strategies such as meta-analysis, simulation, decision analy
Alphabetical list of authors with Scholars@Duke profiles.
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