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Table 1 Characteristics

From: Can in-hospital or post discharge caregiver involvement increase functional performance of older patients? A systematic review

Author
Year
Country
Design (D)
Setting (S)
Sample size (SZ)
Target patient population Intervention (I)
Duration (D)
Frequency (F)
Outcomes (O)
Measure point (MP)
Everink et al.
2018
The Netherlands
D: Prospective cohort study
S: Hospital, geriatric rehabilitation facility, community
SZ: 149 patients 54 caregivers
Geriatric patients (>  65 years and complex health problems)Admitted to a geriatric rehabilitation facilityCommunity-dwelling prior to hospital admission I: Integrated Care Pathway: Process of care during the trajectory of hospital admission, discharge to geriatric rehabilitation and discharge back to community. Patients and their caregiver are actively involved in the triage decision.
D: Period of hospitalization (acute and rehabilitation) until discharge. F: Not stated
O: Patients:Basic functional performance (KI, FAI)Psychological well-being (CSAL)Caregivers:Psychological well-being (SRCB, CSAL)
Others (Discharge location)
MP: Admission geriatric rehabilitation, 3, 6 and 9 months
Forster et al.
2013
UK
D: Multicentre cluster RCT
S: 36 stroke units in four geographical regions.
SZ: 928 patients 928 caregivers
Patient with stroke Medically stable Likely to return home I: London Stroke Carers Training Course:Assessment of competencies in knowledge or skills essential for day-to-day management of disabled survivors of stroke (14 components). Intervention manual and caregiver training record.
D: Period of hospitalization F: Not stated
O: Patients:Basic functional performance (NEADL, BI) Psychological well-being (HADS, EQ-5D)
Caregivers: Psychological well-being (CBS, HADS, EQ-5D)Others (initial stroke admission cost)
MP: Measured at: Baseline, 6 and 12 months
Galvin et al.
2011
Ireland
D: RCT
S: 6 acute hospitals
SZ: 40 patients 40 caregivers
Patient with strokeNo cognitive impairment Participate in a physiotherapy program I: Family-Mediated Exercise Intervention:Training the family member/friend with the skills necessary to carry out the exercise-training programme with the patient.Lower limb exercises designed to patient’s ability. Emphasis on achieving stability, gait velocity and strength
D: 8 weeks F: Training the caregiver on a weekly basisExercises patient-caregiver 35 min daily
O: Patients:Basic functional performance (NEADL, BI, RNLI)
Extended functional performance (LL-FMA, MAS, BBS, 6MWT)Caregivers:Psychological well-being (CSI)
MP: Measured at: Baseline, 8 weeks and 3 months
Gräsel et al.
2005
Germany
D: Non-randomized controlled trialS: 2 study wards of a rehabilitation clinic
SZ: 71 patients 71 caregivers
Patient with strokeFunctional deficit Required treatment in rehabilitation clinic I: Intensified Transition Concept:Psycho-educational seminar for family carers.Individual training course on bedside skills.Therapeutic weekend care, accompanied and monitored by an outpatient care service.Telephone counselling to assess the home situation
D: Duration of hospitalization plus 3 months after discharge F: 1-h psycho-educational seminar3 times 45–60 min individual training course1 therapeutic weekend1 telephone counselling after 3 months
O: Patients:Basic functional performance (BI, FIM)Extended functional performance (TUG, ASS, FAT) Caregivers:Psychological well-being (BSFC, ZDS, GSL)Others (discharge readmission)
MP: Measured at: After intervention, 4 weeks and 6 months
Harris et al.
2010
Canada
D: Subgroup analysis of a RCT
S: Multi-site
SZ: 50 patients 50 caregivers
Patient with strokeActive scapular elevationFM scale 10–57 I: Graded Repetitive Arm Supplementary Program with Caregiver Support:A self-administered upper-limb exercise program, using an exercise booklet and a kit tailored to motor impairment level.Exercises included range of motion, strengthening, and fine motor and goal-directed activities.
D: 4 weeks F: Explanation of the program 1 hExercises 60 min a day, 6 days per weekCaregiver involvement > 2 times/week
O: Patients:Extended functional performance (CAAI, MAL, GS)
MP: Measured at: Baseline and 4 weeks
Hebel et al.
2014 Poland
D: Prospective pre-post study
S: Hospital
SZ: 243 patients 243 caregivers
Patient with stroke I: Voluntary Health Education Program for Carers:Education on stroke and secondary prevention, proper patient positioning in bed and position changing techniques.
D: During hospitalization F: One two-hour meeting
O: Patients:Basic functional performance (NEADL, BI, MRS)
MP: Measured at: After intervention, 3 and 12 months
Kalra et al. Patel et al.
2004UK
D: RCTblock randomisation
S: Hospital, home setting
SZ: 300 patients 300 caregivers
Patient with strokeIndependent in ADL before strokeMedically stableExpected to return home I: Training Caregivers of Stroke Patients:Instructions on common stroke related problems, hands-on training in lifting and handling techniques, facilitation of mobility and transfers, tailored to the needs of individual patients.
D: During hospitalizationF: 3–5 session of 30–45 min1 follow through session at home
O: Patients:Basic functional performance (BI, MRS, FAI)
Psychological well-being (HADS, EQ VAS) Caregivers:Psychological well-being (CBS, HADS, EQ VAS)Others (length of stay, cost, readmission, mortality, discharge destination)
MP: Measured at: Baseline, 1, 3, 6 and 12 months
van den Berg et al.
2016 Australia
D: RCTS: Three hospitals and home setting
SZ: 63 patients 63 caregivers
Patient with stroke Early rehabilitationMobility problemsNo cognitive problems No depression I: Caregiver-Mediated Exercises:A customized exercise app (37 exercises) on a i-pad was provided to the patient and carer.Tele-rehabilitation services after discharge and weekly home visits.
D: 8 weeks (hospital and home) F: ≥5 times per week 30 minweekly evaluation session with PT
O: Patients:Basic functional performance (NEADL, BI, MRS)
Extended functional performance (SISmob, RMI, LL-FMA, MI, TUG, BBS) Psychological well-being (HADS)Caregivers:Psychological well-being (CSI, HADS) Others (Length of stay, Hospital readmission)
MP: Measured at: Baseline, 8 weeks and 12 weeks
  1. 6MWT Six minute walk test, ASS Ashworth Spasticity Scale, BBS Berg Balance Scale, BI Barthel Index, BSFC Burden Scale for Family Carers, CAAI Chedoke Arm and Hand Activity Inventory, CBS Caregiver Burden Scale, CSI Caregiver Strain Index, CSAL Cantril’s Self Anchoring Ladder, CSRI Client Service Receipt Inventory, EQ VAS European Quality of Life Visual Analog Scale, EQ-5D European Quality of Life 5 Descriptive, FAI Frenchay Activities Index, FAT Frenchay Arm Test, FIM Functional Independence Measure, GS Grip strength, GSL Giessen Symptom List, HADS Hospital Anxiety and Depression Scale, KI Katz index, MAL Motor Activity Log, MAS Motor Assessment Scale, MI Motricity index, MRS Modified Rankin Scale, NEADL Nottingham Extended ADL, RMI Rivermead mobility index, RNLI Reintegration to Normal Living Index, SISmob Stroke Impact Scale mobility, SRCB Self Rated Caregiver Burden, TUG Timed up and Go, ZDS Zerssen Depression Scale