Improving older adults stroke survivors’ decision-making when selecting a discharge location: A randomized controlled trial protocol

Abstract

Purpose: Due to disability and reduced activities of daily living (ADL), older adult stroke survivors face difficulties deciding whether to receive care at home or move to a facility after discharge. The study aims to evaluate the impact of decision-aid (DA) use on decision-making participation and conflict regarding the selection of post-discharge care locations for older adult stroke survivors and their families. Data sources: A randomized controlled trial will be conducted among older adult stroke survivors at a medical rehabilitation facility during their recovery period. Randomization units will be blinded and allocated according to the patient's room, and the intervention period will be approximately 2 months, from admission to discharge. The study participants will include (1) people over 65 years of age, (2) stroke survivors, and (3) those facing the need to make decisions regarding the location of post-discharge care. However, those who have difficulty making their own decisions due to severe dementia, aphasia, or altered consciousness will be excluded. In the intervention group, a DA will be provided with its utilization confirmed approximately 1 month after hospitalization. Similarly, the control group will be provided with an informative brochure, with the provision being confirmed approximately 1 month after hospitalization. Data synthesis: The primary outcome (decision-making conflict) and secondary outcome (decision-making participation) will be evaluated using the decisional conflict scale (DCS) and revised control preference scale (CPS), respectively. Intergroup differences in DCS and CPS will be analyzed using two-way repeated measures analysis of variance and z-test, respectively. Conclusions: Verification using randomized controlled trials is necessary to determine the effectiveness and versatility of DAs. Implications for nursing practice: By deepening the knowledge of our priority research areas, the results of the proposed study will strengthen our fundamental knowledge by revealing older adult stroke survivors’ care preferences after discharge.