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Testing a home-telehealth programme for US veterans recovering from stroke and their family caregivers
Authors:Barbara J Lutz  Neale R Chumbler  Teresa Lyles  Nannette Hoffman  Rita Kobb
Institution:1. College of Nursing, University of Florida, Gainesville, Floridabjlutz@ufl.edu;3. VA Health Services Research &4. Development (HSR&5. D), Center of Excellence on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center,;6. Department of Sociology, Indiana University School of Liberal Arts, Indiana University Purdue University, Indianapolis, Indiana;7. VA HSR&8. D Stroke QUERI;9. VA HSR&10. D/Rehabilitation Research &11. Development (RR&12. D) Rehabilitation Outcomes Research Center,;13. Geriatrics and Extended Care,;14. Sunshine Training Center, North Florida/South Georgia Veterans Health System, Gainesville/Lake City, Florida, USA
Abstract:Purpose. The study purpose was to implement a stroke-specific, care coordination home telehealth (CCHT) programme for US veterans with stroke and their family caregivers.

Methods. In a non-randomized open trial using a mixed methods design, we tested the utility of a stroke-specific, home telehealth programme with 18 veterans and 14 caregivers for 14 days. Programme questions assessed physical impairment, depressive symptoms, and fall prevalence among veterans, and burden level among family caregivers. Nine veterans and six caregivers completed post-programme interviews exploring their experiences with telehealth.

Results. During the 14-day trial, 55% of the veterans screened positive for depression at least once, 36% of the caregivers had clinically significant burden, half of the veterans and caregivers reported post-stroke concerns, and 90% believed post-stroke contact from a care coordinator would have been helpful. In the interviews, seven veterans indicated they had fallen or almost fallen post-stroke. Themes centred on tailoring CCHT to individual needs, coordinating with support services, identifying safety issues, and providing information about stroke prevention.

Conclusions. Home telehealth offers innovative ways to target post-stroke rehabilitation programmes to the needs and concerns of patients and their caregivers, and should include regular real-time contact between stroke patients and their healthcare providers.
Keywords:Telehealth  stroke  caregiver  rehabilitation  home care
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