Introduction: Few studies have explored unscripted conversations with stroke survivors during the post-discharge period to determine areas of need and concern. Additional contact during the transition period may provide a better understanding of patient needs once home.
Methods: Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) was an RCT of a skills-based educational intervention among mild stroke/TIA patients, which included follow-up calls from a research coordinator at 72 hours, 1 month and 3 months post discharge. Follow-up forms (N=651, 242 patients) were reviewed and a codebook, consisting of 30 unique codes, was created to capture conversational themes. Two coders independently conducted systematic-content-analysis on the textual data. Discrepancies were examined and adjudicated by a third coder. Frequencies were calculated to determine the most prevalent conversational themes. Associations between themes and patient demographics were then assessed using chi-square tests.
Results: The most frequent conversation topics identified were: 1) setting up medical and neurological appointments (70.97%), 2) good medication adherence (16.28%) and 3) complaints of post-stroke symptoms (12.29%). Additionally, we found a significantly higher prevalence of non-Hispanic blacks and Hispanics complaining of post-stroke symptom to the health coordinator (54.4% and 49.2%, respectively) compared to non-Hispanic whites (25.0%, P=0.008). Although not statistically significant, we observed a higher prevalence of complaints of post-stroke symptoms among unmarried individuals (51.2% vs 40.2%, P=0.149) and people who live alone (53.2% vs 41.0%, P=0.248).
Conclusions: In this sample of mild stroke/TIA patients from the DESERVE study, we found that stroke survivors’ main concerns during the post-discharge period include setting up medical appointments, medication adherence, and post-stroke symptoms. Furthermore, these concerns varied by race-ethnic group, marital status and living arrangement. Future interventions should be tailored to address these concerns, especially once the patient has transitioned home.