Evidence-Based Educational Guidelines for Stroke Survivors After Discharge Home

Sharon K. Ostwald, PhD RN FGSA; Sally Davis, MSN RN; Gayle Hersch, PhD OTR; Carolyn Kelley, DScPT PT NCS; Kyler M. Godwin, MPH


J Neurosci Nurs. 2008;40(3):173-179,191. 

In This Article

Guideline Evaluation

Education, support, skill training, and counseling were provided during home visits. Follow-up contacts and referrals usually were handled via telephone. Between 2001 and 2006, 72 stroke survivors and family caregivers received the home-based educational program using the guidelines outlined in Figure 1. The team spent 2,644 hours during 1,150 visits with stroke survivors and families throughout this program's duration. Over 6 months, the average family received 16 visits (range = 8–34), for a total of 36.7 hours (range = 17–80 hours) of education. The mean length of each visit was just over 70 minutes, and nurses and therapists used an average of 25 guidelines over the 6 months based on the survivors' and families' needs. The average family received education using 20 guidelines provided by the APNs, three guidelines given by the occupational therapist, and two guidelines given by the physical therapist.

At the conclusion of each visit, the team member assessed her perceptions of how well the stroke survivor and caregiver understood the content provided during the session (see Fig 2). The nurses and therapists reported that 63% of stroke survivors and 85% of caregivers indicated they understood the content well, while only 6% of stroke survivors and less than 1% of caregivers had significant difficulty understanding the content. Guideline content was repeated as often as necessary, especially if the survivor or family did not understand it or if the situation changed (i.e., new hospital admission). Families were provided with evaluation forms and were asked to anonymously return the forms in self-addressed stamped envelopes to report their satisfaction with the educational program. Most family participants (83.75%) returned at least one evaluation form. The average number of evaluations returned by each family was 4.7 (range = 1–7). In total, families returned 314 evaluation forms and reported overwhelming satisfaction (3.80, range = 2.8–4) on a scale of 1 (not satisfied) to 4 (very satisfied).


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