Outreach nurse support after stroke: a descriptive study on patients' and carers' needs, and applied nursing interventions

Objective: To describe the number and types of problems mentioned by successfully contacted home-dwelling stroke patients and their carers, and nursing interventions applied. Design: In this multicentre quantitative study in the Netherlands, stroke patients and carers received outreach nurse support consisting of three telephone contacts and one home visit within six months after discharge. Standardized checklists describing a wide range of potential problems were used to record problems and interventions. Subjects: A sample of 173 patients admitted for a stroke and discharged home, and 148 carers. Results: Of 173 patients, 166 (96%) were contacted and 162 mentioned in total 1419 problems. Physical problems were mentioned most frequently (92%; 153/166), followed by emotional problems (60%; 99/166). The proportion of patients with problems decreased from 94% (142/151) at the first contact to 74% (108/145) at the last contact. Of 148 carers, 118 (80%) were contacted and 84 mentioned 266 problems. 'Psychosocial burden' was mentioned most frequently (45%; 53/118). Proportions of carers with problems were 56% (54/96) at the first contact and 37% (26/70) at the last contact. Of 864 interventions to patients, stroke nurses most frequently applied 'supportive listening' (55%; 471/864) and 'reassuring or encouraging' (12%; 107/864), and of 258 interventions to carers 45% (115/258) were 'supportive listening' and 17% (43/258) 'informing'. Conclusions: Almost all patients and most carers were contacted. Though the number of needs decreased during the consecutive contacts, many patients and carers still raised problems during the last contact. Nurses most frequently applied the intervention 'supportive listening'.