82 Needs of stroke survivors after acute stroke and early supported discharge (ESD), at hospital discharge, and at 3- and 6-months

Abstract

Abstract Background There are gaps in our understanding of the needs of Irish stroke survivors as they return home from hospital, and in the first six months following their stroke. Methods We conducted a prospective cohort study in stroke survivors, recruited from three hospital sites across Ireland and profiled their self-reported needs in relation to information, recovery and community re-integration at discharge to home after acute hospitalisation, rehabilitation or early supported discharge, and described ongoing needs over a 6-month period. Results 72 participants, mean age 70 (SD: 13), 61% female, mean NIHSS score 6.3 (SD 6), were recruited at hospital discharge. Needs were gathered on 59 participants (82%) at 7–10 days post discharge, 54 participants (75%) at 3-months, and 45 participants (63%) at 6-months. 40% of respondents reported no unmet needs at discharge, at 3-months 20% reported no unmet needs. The median number of unmet needs was 3 (range, 1–8). Over 50% of respondents reported not having an opportunity to discuss their transition plan before their discharge home. At hospital discharge, people with stroke reported challenges around mobility and falls (>85%), fatigue (73%), emotional issues (66%), and memory (46%); with emotional problems, fatigue, and memory difficulties rating as highest levels of unmet need. Over 40% needed support with housework. In relation to information after stroke, (80%) needed information about their stroke, support around nutrition (51%), return to driving (40%) and financial concerns (32%). These rehabilitation, information and support needs persisted at 3- and 6- months. Conclusion Successful community re-integration after stroke is a complex process for the person with stroke and their family. Our findings concur with those of international-based researchers, that the prevalence of unmet needs is high among stroke survivors. Profiling needs of people with stroke is important to shape the development of therapies to reduce unmet need following a stroke.