Expanding the Role of the Stroke Nurse
I S S U E S A N D IN N O V A T I O N S IN N U R S I N G P R A C T I C E
Expanding the role of the stroke nurse: a pragmatic clinical trial
Christopher Burton
DPhil PGCertHE BN RGN
Research Fellow, Department of Nursing, University of Central Lancashire, Preston, UK
Bernard Gibbon
PhD MSc DipN DipANS RMN RGN
Head of Department, Department of Nursing, University of Central Lancashire, Preston, UK
Accepted for publication 16 March 2005
Correspondence: Christopher Burton, Department of Nursing, University of Central Lancashire, Preston PR1 2HE, UK. E-mail: c.burton1@whsmithnet.co.uk
B U R T O N C . & G I B B O N B . ( 2 0 0 5 ) Journal of Advanced Nursing 52(6), 640–650 Expanding the role of the stroke nurse: a pragmatic clinical trial Aims. This paper reports a study evaluating whether expanding a specialist nursing role to provide outreach education and support to stroke patients and carers after discharge from hospital is effective in promoting recovery. Background. Building therapeutic relationships with patients and carers is a key component of the nursing role in stroke rehabilitation, although this is limited by the constraints of service organization. Methods. A pragmatic randomized controlled trial was undertaken. Patients with a diagnosis of stroke were randomized to receive continued support from a stroke nurse (n ¼ 87) or usual care and follow-up (n ¼ 89) after discharge from hospital. Patients were recruited from two hospitals in the north-west of England from November 1999 to April 2001. Patient dependence (Barthel Index), general health (Nottingham Health Profile), activities of living (Frenchay Activity of Living Index), depression (Beck Depression Inventory) and carer strain (Carer Strain Index) were assessed at 3 and 12 months after stroke. Results. The continued intervention of a stroke nurse after discharge was associated with improved patient perceptions of general health at 12 months (median difference 42Æ6, P ¼ 0Æ012),
Expanding the role of the stroke nurse: a pragmatic clinical trial
Christopher Burton
DPhil PGCertHE BN RGN
Research Fellow, Department of Nursing, University of Central Lancashire, Preston, UK
Bernard Gibbon
PhD MSc DipN DipANS RMN RGN
Head of Department, Department of Nursing, University of Central Lancashire, Preston, UK
Accepted for publication 16 March 2005
Correspondence: Christopher Burton, Department of Nursing, University of Central Lancashire, Preston PR1 2HE, UK. E-mail: c.burton1@whsmithnet.co.uk
B U R T O N C . & G I B B O N B . ( 2 0 0 5 ) Journal of Advanced Nursing 52(6), 640–650 Expanding the role of the stroke nurse: a pragmatic clinical trial Aims. This paper reports a study evaluating whether expanding a specialist nursing role to provide outreach education and support to stroke patients and carers after discharge from hospital is effective in promoting recovery. Background. Building therapeutic relationships with patients and carers is a key component of the nursing role in stroke rehabilitation, although this is limited by the constraints of service organization. Methods. A pragmatic randomized controlled trial was undertaken. Patients with a diagnosis of stroke were randomized to receive continued support from a stroke nurse (n ¼ 87) or usual care and follow-up (n ¼ 89) after discharge from hospital. Patients were recruited from two hospitals in the north-west of England from November 1999 to April 2001. Patient dependence (Barthel Index), general health (Nottingham Health Profile), activities of living (Frenchay Activity of Living Index), depression (Beck Depression Inventory) and carer strain (Carer Strain Index) were assessed at 3 and 12 months after stroke. Results. The continued intervention of a stroke nurse after discharge was associated with improved patient perceptions of general health at 12 months (median difference 42Æ6, P ¼ 0Æ012),
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