Using the Preparedness Assessment for the Transition Home After Stroke Instrument to Identify Stroke Caregiver Concerns Predischarge: Uncertainty, Anticipation, and Cues to Action

Stroke survivors and their caregivers face enormous challenges as they transition from the IRF to home. As rehab nurses, we make every effort to educate caregivers about what to expect at home, but often they are unprepared to the role they are committing to. The Preparedness Assessment for the Transition Home After Stroke (PATH-s) is a 25-item instrument designed to assess stroke survivor caregiver readiness to care for the stroke survivor when they are discharged home. The study involved interviewing caregivers after they had completed the instrument and before their family member was discharged. During the interviews, participants were asked to 'think out loud' about what their thoughts were when responding to each question. The data the researchers received improved the item validity and relevance of the instrument, and also helped make the caregivers aware of the concerns they had about the caregiving role.

Abstract

Purpose 

The aim of the study was to better understand caregivers’ concerns about long-term implications of stroke and the caregiving role after completing the Preparedness Assessment for the Transition Home After Stroke (PATH-s).

Design/Methods 

In this qualitative study, cognitive interviews were conducted with 20 stroke caregivers who completed the PATH-s tool as part of an instrument validation study. Data were analyzed for salient themes related to their perceptions about stroke and the caregiving role.

Findings 

Interviews yielded robust narrative data describing how the PATH-s items aided caregivers in recognizing potential issues and concerns about stroke and the caregiving role. Caregivers experienced uncertainty about the long-term stroke prognosis, which provoked anticipation and cues to action to begin addressing their concerns.

Conclusions/Clinical Relevance 

Completing the PATH-s helped caregivers identify concerns regarding the long-term implications of stroke and their caregiving role. It may serve as an important assessment tool to assist rehabilitation nurses to better understand and address caregiver needs predischarge.