Domiciliary Care Service: Factors Influencing Improvement in Activities of Daily Living Among Stroke Survivors

Abstract

Stroke is a debilitating disease, adding to morbidity and mortality. Home-based rehabilitation has an influence on functional recovery among stroke survivors. This study aimed to determine factors influencing the improvement in activities of daily living (ADL) among stroke survivors after domiciliary care service. A state-wide record-review study using Domiciliary Care Record from health clinics with comprehensive domiciliary care was conducted. A logistic regression (LR) model was performed to assess factors influencing ADL improvement. Improved ADL was defined as obtaining at least 30% improvement on the Modified Barthel Index at the end of the program. From the records review, 72.2% of the participants had improved ADL following domiciliary care service. The mean age of the sample was 68.21 years ( SD = 11.99). The majority were ischemic stroke survivors (81.2%). In the single LR model, the influencing factors of ADL improvement were younger age (odds ratio [OR] = 2.76; p = .004), married (OR = 2.04; p = .018), ischemic stroke type (OR = 6.35; p < .001), less severe stroke (OR = 4.18; p < .001), no previous stroke (OR = 4.24; p < .001), and 9 to 12 home visits (OR = 2.79; p < .006). The multiple LR model showed ischemic stroke type (adjusted odds ratio [Adj. OR] = 5.30; p < .001), less severe stroke (Modified Rankin Scale score = 4; Adj. OR = 3.70; p < .001), and no previous stroke (Adj. OR = 3.51; p = .001) as significant factors when adjusted for other variables. Recognition of these factors associated with the improvement in stroke recovery is beneficial to intensify an optimal stroke care and home-based rehabilitation services.