Effectiveness of Innovative Transitional Care Program in Improving Post Discharged Outcomes Among Caregivers of Traumatic Brain Injury Survivors: A Randomized Controlled Trial

Abstract

Caring for patients with traumatic brain injury (TBI) during the transition period from hospital to home can cause psychological disturbances to caregivers. Nursing interventions to support these caregivers delivered before discharge and continuing into the community might improve their mental health outcomes. The study aimed to assess the effectiveness of an innovative transitional care program in improving post-discharge outcomes among caregivers of TBI survivors. A randomized controlled trial study was conducted. Random Allocation Software allocated 74 study participants to the intervention or control group. Then, 37 participants were included in the intervention group, while 37 were included in the control group. Outcomes were measured at 3-time points: at hospital discharge (T0), two (T1) and four (T2) weeks post-discharge. The intervention instrument was an innovative transitional care program. Another two instruments, including Caregiver Stress Self-Assessment and Zarit Burden Interview, were used for data collection. The corrected item-total correlation of Caregiver Stress Self-Assessment ranges from .77 to .95, with the Cronbach’s alpha value of .91. In comparison, the range of the corrected item-total correlation of the Short-Zarit Burden Interview from .69 to .93, with Cronbach’s alpha value of 0.88. Data were analyzed using repeated-measure ANOVA. The findings showed that stress within the intervention group decreased over time (p<.001, MD = 11.05). Both groups' stress was significantly different at T1 and T2 (p<.001). The caregiver burden showed similar results (T1 p<.001 and T2 p<.001). Only one patient in the control group was readmitted to the hospital, while no patients were readmitted in the intervention group. The innovative transitional care intervention reduced the stress and burden of caregivers of patients with moderate or severe TBI. Nurses must consider using mobile application to support caregivers from the hospital into the community.