Authors (including presenting author) :
Karin Chow YL(1), Fonny Ng YH(2) , Ostin Lai (2) Liu ML (1), TMH Stroke nursing team (1)
Affiliation :
(1) Acute Stroke Unit, Department of Medicine & Geriatrics, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority. (2) Patient Resources Centre, Tuen Mun Hospital
Introduction :
Stroke can be a devastating and life changing event for people. 2 out of 5 stroke survivors in TMH ASU discharge directly, post stroke supported services were expected to build around their individual needs with board range of services to help them recover from and cope with the effects of stroke. However, services provided were varies and fragmented, age below 60y would not be included in Geriatric-day training, while patients on discharged with modified rankin scale (mRS) 0 -3 were relatively low in priority to transfer to Rehabilitation Stroke Unit. More than 90% of discharged patients from ASU had to wait four weeks on average until they receive community-based physiotherapy, occupational therapy and speech and language therapy. Although some information packs provided a helpline on local services, almost all were not available outside office hours and without a named contact person to introduce their services, which sometimes patients cannot talk. An innovative group program, collaborated with Social worker (SW) of Community Service center and Non-government Organizations (NGOs) has been established in April 2017, consist of 2 hours for 4 times. Patients can come with carers and participate in interactive information sessions and peer-to-peer sharing group. The key part of this program is some of our previously participants to act as volunteers in this program
Objectives :
• To provide self-management support • To promote peer-to-peer support • To build up patient’s confidence and mindset change so as to re-engage in healthy lifestyle behaviors.
Methodology :
• Data collected from 17/4/2017 to 31/12/2019 by TMH stroke nursing team • All ASU admitted patients were inclusive and recruited under voluntary base. • Participants with 2 or more attendance will be recruited for data analysis via telephone consultation by SW , 1 pre & post survey to examine stroke knowledge. 1 post survey to evaluate the effectiveness of peer-to-peer support 1 post survey to evaluate the effectiveness of information transfer for community-based rehabilitation services.
Result & Outcome :
There were total 1025 patients referred with 343 patients and 270 carers attended the support group. Stroke knowledge increased from 44% to 100% after program attended. 96% patients satisfied and agreed they were empowered by each other, they will continue to follow healthy behaviors outside the program, where they have confidence in doing daily important activities. Total 70 patients enrolled to NGOs services, of which, 40 patients and carers (57%) attended 40 episodes of NGOs’ activities. There are 3 patients became the volunteers and influencer to support this program in final. Conclusion and recommendation: The service has been evolved since 2019, classes modified to a two-hour based sharing session plus 10 times of different trial activities provided by NGOs. While all classes changed to a virtual format in 2020 due to pandemic of COVID-19 with total 8 classes held. Although only 65 patients and carer were joined, we were surprised by the seniors/survivors that they were willing to learn new technology/skills and participated actively in the group. All participants including the volunteers were felt very content to keep in touch with the community through web-based format even under the isolation policy. Although the group is small in scale, it has rooms for improvement, we formed a stroke community where good habits are spread by patients themselves. The power of peers and community support are impressed and it is one of the important elements in post stroke rehabilitation journey.
