Impact of Interprofessional Collaborative Practice on Functional Improvements Among Post-Acute Stroke Survivors: A Retrospective Cross-Sectional Study

Abstract

Tsen-Pei Chen,1,2 Ying-Jia Lin,3 Yu-Lin Wang,4,5 Li-Min Wu,2,6 Chung-Han Ho3,7,8 1Department of Nursing, Chi Mei Medical Center, Tainan City, Taiwan; 2School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan; 3Department of Medical Research, Chi Mei Medical Center, Tainan City, Taiwan; 4Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan City, Taiwan; 5Department of Biomedical Engineering, National Cheng Kung University, Tainan,Taiwan; 6Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; 7Department of Information Management, Southern Taiwan University of Science and Technology, Tainan City, Taiwan; 8Cancer Center, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, TaiwanCorrespondence: Li-Min Wu, School of Nursing, Department of Medical Research, Kaohsiung Medical University Hospital, No. 100, Shin-Chuan 1st Road., Sanmin District, Kaohsiung City, 807378, Taiwan, Email [email protected] Chung-Han Ho, Department of Medical Research, Chi Mei Medical Center, No. 901, Chung Hwa Road, Yongkang Dist, Tainan City, 710, Taiwan, Email [email protected]: Stroke survivors in post-acute care frequently experience physiological dysfunction and reduced quality of life. This study aims to assess the impact of the Post-Acute Care Interprofessional Collaborative Practice (PAC-IPCP) program across different care settings, and to identify sensitive tools for assessing physiological functions among post-acute stroke survivors.Methods: This retrospective study involved 210 stroke survivors in Taiwan. Participants who self-selection for their preferred between hospital care setting and home care setting under PAC-IPCP. Multiple assessment tools were utilized, including the Barthel Index (BI), Functional Oral Intake Scale (FOIS), Mini Nutritional Assessment (MNA), EQ-5D-3L, and Instrumental Activities of Daily Living (IADL). The logistic regression was used to estimate the odds ratios of various functional assessment tools between hospital and home care settings. Additionally, the area under the ROC curves was used to determine which functional assessment tools had higher accuracy in measuring the association between care settings.Results: Of the study population, 138 stroke survivors (65.71%) selection hospital care setting and 72 stroke survivors (34.29%) selection home care setting. The PAC-IPCP program was equally effective in both care settings for physical function status and quality of life improvements. Specifically, the BI emerged as the most sensitive tool for assessing care settings, with an adjusted OR of 1.04 (95% CI:1.02– 1.07, p < 0.0001; AUC = 0.7557). IPCP-based hospital and home care models are equally effective in facilitating improved functional outcomes in post-acute stroke survivors.Conclusion: The PAC-IPCP program is versatile and effective across care settings. The BI stands out as a robust assessment tool for physiological functions, endorsing its broader clinical application. Future studies should also consider swallowing and nutritional status for a more holistic approach to rehabilitation.Keywords: stroke, neurology, subacute care, recovery of function, health care

Keywords

• stroke
• neurology
• subacute care
• recovery of function
• health care