Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-23T05:48:20.931Z Has data issue: false hasContentIssue false
  • English
  • Français

Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care

Published online by Cambridge University Press:  02 December 2014

Maureen Markle-Reid ,
Camille Orridge ,
Robin Weir ,
Gina Browne ,
Amiram Gafni ,
Mary Lewis ,
Marian Walsh ,
Charissa Levy ,
Stacey Daub  and
Heather Brien
...Show all authors
Maureen Markle-Reid*
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Camille Orridge
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Robin Weir
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Gina Browne
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Amiram Gafni
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Mary Lewis
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Marian Walsh
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Charissa Levy
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Stacey Daub
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Heather Brien
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Jacqueline Roberts
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
Lehana Thabane
Affiliation:
School of Nursing, McMaster University, Hamilton, Ontario, Canada
*
McMaster University, School of Nursing, 1200 Main Street West, HSC 3N28H, Hamilton, Ontario, L8N 3Z5, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.

Methods:

Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.

Results:

A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).

Conclusions:

A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 2 , March 2011 , pp. 317 - 334
Copyright
Copyright © The Canadian Journal of Neurological 2011

References

1Mayo, NE, Wood-Dauphinee, S, Côt’, R, Durcan, L, Carlton, J.Activity, participation, and quality of life 6 months poststroke. Arch Phys Med Rehabil. 2002;83(8):1035–42.CrossRefGoogle ScholarPubMed
2Flick, CL.Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences. Arch Phys Med Rehabil. 1999;80(5 Suppl 1): S21–6.CrossRefGoogle ScholarPubMed
3Gresham, GE, Duncan, PW, Stason, WB, et al.Post-stroke rehabilitation. Clinical practice guideline, No 16. Rockville, MD: U. S. Department of Health and Human Services. Public Health Service, Agency for Health Care Policy and Research; 1995 [cited 2009 Nov 27]. Available from: www.ncbi.nlm.nih.govGoogle Scholar
4Health, Canada. Economic burden of illness in Canada. Ottawa, Ontario: Health Canada; 1998 [cited 2009 Nov 27]. Available from: www.phac-aspc.gc.caGoogle Scholar
5Heart and Stroke Foundation of Canada. The growing burden of heart disease and stroke in Canada. Ottawa, Ontario: Heart and Stroke Foundation of Canada; 2003 [cited 2009 Nov 27]. Available from: www.cvdinfobase.caGoogle Scholar
6Heart and Stroke Foundation of Ontario. Stroke statistics. Toronto, Ontario: Heart and Stroke Foundation of Ontario; 2004 [cited 2009 Oct 14]. Available from: www.heartandstroke.caGoogle Scholar
7Heart and Stroke Foundation of Ontario. Best practice guidelines for stroke care: community re-engagement. Toronto, Ontario: Heart and Stroke Foundation of Ontario; 2003 [cited 2009 Nov 27]. Available from: www.heartandstroke.on.caGoogle Scholar
8Katzmarzyk, PT.The Canadian obesity epidemic, 1985-1998. CMAJ. 2002;166(8):1039–40.Google ScholarPubMed
9Young, J, Forster, A.Review of stroke rehabilitation. BMJ. 2007;334 (7584):86–90.CrossRefGoogle ScholarPubMed
10Han, B, Haley, WE.Family caregiving for patients with stroke: review and analysis. Stroke. 1999;30(7):1478–85.CrossRefGoogle ScholarPubMed
11Hartman-Maeir, A, Soroker, N, Ring, H, Avni, N, Katz, N.Activities, participation and satisfaction one-year post stroke. Disabil Rehabil. 2007;29(7):559–66.CrossRefGoogle ScholarPubMed
12Hopman, WM, Verner, J.Quality of life during and after inpatient stroke rehabilitation. Stroke. 2003;34(3):801–5.CrossRefGoogle ScholarPubMed
13Patel, MD, Tilling, K, Lawrence, E, Rudd, AG, Wolfe, CD, McKevitt, C.Relationships between long-term stroke disability, handicap and health-related quality of life. Age Ageing. 2006;35(3):273–9.CrossRefGoogle ScholarPubMed
14McKevitt, C, Redfern, J, Mold, F, Wolfe, C.Qualitative studies of stroke: a systematic review. Stroke. 2004;35(6):1499–505.CrossRefGoogle ScholarPubMed
15Hackett, ML, Yapa, C, Parag, V, Anderson, CS.Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005;36(6):1330–40.CrossRefGoogle ScholarPubMed
16Young, J, Murray, J, Foster, A.Review of longer-term problems after disabling stroke. Rev Clin Gerontol. 2003;13:55–65.CrossRefGoogle Scholar
17Ellis, G, Stroke Liaison Workers Collaboration. Meta-analysis of stroke liaison workers for patients and carers: results by intervention characteristic. Cerebrovasc Dis. 2006;21(Suppl 4): 120.Google Scholar
18Anderson, C, Mhurchu, CN, Brown, PM, Carter, K.Stroke rehabilitation services to accelerate hospital discharge and provide home-based care. Pharmacoeconomics. 2002;20(8): 537–52.CrossRefGoogle ScholarPubMed
19Ciechanowski, P, Wagner, E, Schmaling, K, et al.Community-integrated home-based depression treatment in older adults: a randomized controlled trial. JAMA. 2004;291(13):1569–7.CrossRefGoogle ScholarPubMed
20Young, J, Forster, A.The Bradford community stroke trial: results at six months. BMJ. 1992;304(6834):1085–9.CrossRefGoogle ScholarPubMed
21White, JH, Alston, MK, Marqez, JL, et al.Community-dwelling stroke survivors: function is not the whole story with quality of life. Arch Phys Med Rehabil. 2007;88(9):1140–6.CrossRefGoogle Scholar
22Dewey, HM, Sherry, LJ, Collier, JM.Stroke rehabilitation 2007: what should it be? Int J Stroke. 2007;2(3):191–200.CrossRefGoogle Scholar
23Stroke Unit Trialists’ Collaboration. Organized inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev. 2007;(4): CD000197.Google Scholar
24Stroke Unit Trialists’ Collaboration. A collaborative systematic review of the randomized trials of organized inpatient (stroke unit) care after first stroke. BMJ. 1997;314(7088):1151–9.CrossRefGoogle Scholar
25Stroke Unit Trialists’ Collaboration. How do stroke units improve patient outcomes? A collaborative systematic review of the randomized trials. Stroke. 1997;28(11):2139–44.CrossRefGoogle Scholar
26Ronning, OM, Gudvog, B.Outcome of subacute rehabilitation: a randomized controlled trial. Stroke. 1998;29(4):779–84.CrossRefGoogle ScholarPubMed
27Early Supported Discharge Trialists. Services for reducing duration of hospital care for acute stroke patients. Cochrane Database Syst Rev. 2005;(2):CD000443.Google Scholar
28Mayo, N, Wood-Dauphinee, S, Côt’, R, et al.There’s no place like home: an evaluation of early supported discharge for stroke. Stroke. 2000;31(5):1016–23.CrossRefGoogle ScholarPubMed
29Indredavik, B, Fjaertoft, H, Ekeberg, G, Løge, AD, Mørch, B.Benefit of an extended stroke unit service with early supported discharge: a randomized, controlled trial. Stroke. 2000;31(12): 2989–94.CrossRefGoogle ScholarPubMed
30Anderson, C, Rubenach, S, Mhurchu, C, Clark, M, Spencer, C, Winsor, A.Home or hospital for stroke rehabilitation? Results of a randomized controlled trial: I: health outcomes at 6 months. Stroke. 2000;31(5):1024–31.CrossRefGoogle ScholarPubMed
31Langhorne, P, Gillian, T, Murray, G, et al.Early supported discharge services for stroke patients: a meta-analysis of individual patients’ data. Lancet. 2005;365(9458):501–6.CrossRefGoogle ScholarPubMed
32Teasell, RW, Foley, NC, Bhogal, SK, Speechley, MR.An evidence-based review of stroke rehabilitation. Top Stroke Rehabil. 2003; 10(1):29–58.CrossRefGoogle ScholarPubMed
33Larsen, T, Olsen, TS, Sorensen, J.Early home-supported discharge of stroke patients: a health technology assessment. Int J Technol Assess Health Care. 2006;22(3):313–20.CrossRefGoogle ScholarPubMed
34Holmqvist, L, Widen, RPT, von Koch, L, et al.A randomized controlled trial of rehabilitation at home after stroke in southwest Stockholm. Stroke. 1998;29(3):591–7.CrossRefGoogle Scholar
35Rudd, AG, Wolfe, CD, Tilling, K, Beech, R.Randomized controlled trial to evaluate early discharge scheme for patients with stroke. BMJ. 1997;315(1775):1039–44.CrossRefGoogle ScholarPubMed
36Rodgers, H, Soutter, J, Kaiser, W, et al.Early supported discharge following acute stroke: pilot study results. Clin Rehabil. 1997; 11:280–7.CrossRefGoogle ScholarPubMed
37McNamee, P, Chrjstensen, J, Soutter, J, et al.Cost analysis of early supported discharge for stroke. Age Ageing. 1998;27:345–51.CrossRefGoogle Scholar
38Bautz-Holter, E, Sveen, U, Rygh, J, Rodgers, H, Wyller, TB.Early supported discharge of patients with acute stroke: a randomized controlled trial. Disabil Rehabil. 2002;24(7):348–55.CrossRefGoogle ScholarPubMed
39Pessah-Rasmussen, H, Wendel, K.Early supported discharge after stroke and continued rehabilitation at home coordinated and delivered by a stroke unit in an urban area. J Rehabil Med. 2009;41(6):482–8.CrossRefGoogle Scholar
40Fjaertoft, H, Indredavik, B, Lydersen, S.Stroke unit care combined with early supported discharge: long-term follow-up of a randomized controlled trial. Stroke. 2003;34(11):2687–92.CrossRefGoogle ScholarPubMed
41Lincoln, NB, Walker, MF, Dixon, A, Knights, P.Evaluation of a multiprofessional community stroke team: a randomized control trial. Clin Rehabil. 2004;18(1):40–7.CrossRefGoogle Scholar
42Teng, J, Mayo, NE, Latimer, E, et al.Costs and caregiver consequences of early supported discharge for stroke patients. Stroke. 2003;34(2):528–36.CrossRefGoogle ScholarPubMed
43Donnelly, M, Power, M, Russell, M, Fullerton, K.Randomized controlled trial of an early discharge rehabilitation service: the Belfast community stroke trial. Stroke. 2004;35(1):127–33.CrossRefGoogle ScholarPubMed
44Canadian Stroke Network, Heart and Stroke Foundation of Canada. Billions of dollars, tens of thousands of lives at stake-Why aren’t proven stroke solutions being used consistently in Canada? Ottawa, Ontario: Canadian Stroke Network; 2006 [cited 2009 Nov 27]. Available from: www.canadianstrokestrategy.caGoogle Scholar
45Ontario Ministry of Health and Long-Term Care. Report of the joint stroke strategy working group. Toronto, Ontario: Ontario Ministry of Health and Long-Term Care; 2000 [cited 2009 Nov 27]. Available from: www.health.gov.on.caGoogle Scholar
46Canadian Stroke Network. Stroke Canada Optimization of Rehabilitation by Evidence (SCORE) project. Ottawa, Ontario: Canadian Stroke Network; 2004 [cited 2010 Aug 1]. Available from: http://www.canadianstrokenetwork.ca/eng/tools/index.phpGoogle Scholar
47Canadian Stroke Network. Integrated stroke care in Ontario: stroke evaluation report. Ottawa, Ontario: Canadian Stroke Network; 2006 [cited 2009 Nov 27]. Available from: www.canadianstrokestrategy.caGoogle Scholar
48Langhorne, P.Editorial comment - Early supported discharge: an idea whose time has come? Stroke. 2003;34(11):2691–2.CrossRefGoogle ScholarPubMed
49Mayo, NE, Nadeau, L, Ahmed, S, et al.Bridging the gap: the effectiveness of teaming a stroke coordinator with patient’s personal physician on the outcome of stroke. Age Ageing. 2008; 37(1):32–8.CrossRefGoogle Scholar
50Hale, LA.Community-based or home-based stroke rehabilitation: confusion or common sense? NZ J Physiother. 2004;32(3): 131–9.Google Scholar
51Canadian Home Care Association. Home care: the next essential service: meeting the needs of our aging population. Ottawa, Ontario: Canadian Home Care Association; 2008 [cited 2009 Nov 27]. Available from: www.cdnhomecare.caGoogle Scholar
52Teasell, RW, Foley, NC, Salter, K, Bhogal, S, Jutai, J, Speechley, M.Evidence-based review of stroke rehabilitation 12th ed. [Internet]. London, Ontario; 2009 [cited 2009 Nov 27]. Available from: www.ebrsr.comGoogle Scholar
53Bayley, M, Lindsay, P, Hellings, C, Woodbury, E, Phillips, S.Balancing evidence and opinion in stroke care: Canadian best practice recommendations for stroke care: summary. CMAJ. 2008;179 Suppl 12:S1–25.Google Scholar
54Lindsay, P, Bayley, M, Hellings, C, Hill, M, Woodbury, E, Phillips, S.Canadian best practice recommendations for stroke care (updated 2008). CMAJ. 2008;179(12):S1–19.CrossRefGoogle Scholar
55Ostwald, SK, Davis, S, Hersch, G, Kelley, C, Godwin, KM.Evidence-based educational guidelines for stroke survivors after discharge home. J Neurosc Nurs. 2008;40(3):173–91.CrossRefGoogle ScholarPubMed
56Strasser, DC, Falconer, JA, Stevens, AB, et al.Team training and stroke rehabilitation outcomes: a cluster randomized trial. Arch Phys Med Rehabil. 2008;89(1):10–5.CrossRefGoogle ScholarPubMed
57West GTA Stroke Network. Community stroke best practice guidelines. Toronto, Ontario: Heart and Stroke Foundation of Ontario; 2005 [cited 2009 Nov 27]. Available from: www.heartandstroke.on.caGoogle Scholar
58Korner-Bitensky, N, Wood-Dauphinee, S, Teasell, R, et al.Best versus actual practices in stroke rehabilitation: results of the Canadian National Survey. 6th World Stroke Congress. Stroke. 2006;37:631.Google Scholar
59Menon, A, Korner-Bitensky, N, Kastner, M, McKibbon, KA, Straus, S.Strategies for rehabilitation professionals to move evidence-based knowledge into practice: a systematic review. J Rehabil Med. 2009;41:1024–32.CrossRefGoogle ScholarPubMed
60Lindsay, P, Bayley, M, McDonald, A, Graham, ID, Warner, G, Phillips, S.Toward a more effective approach to stroke: Canadian best practice recommendations for stroke care. CMAJ. 2008;178(11): 1418–25.CrossRefGoogle Scholar
61Anderson, M, Parent, K.Care in the home: public responsibility-private role. Kingston, Ontario: Queen’s University, Department of Rehabilitation Medicine; 2000 [cited 2009 Nov 27]. Available from: www.utoronto.ca/hpme/dhr/pdf/Anderson_Parent.pdfGoogle Scholar
62Canadian Home Care Association. Home care: a national health priority: visionary leadership can make it happen. Ottawa: Canadian Home Care Association; 2004.Google Scholar
63Coyte, PC, McKeever, P.Home care in Canada: passing the buck. Can J Nurs Res. 2001;33(2):11–25.Google ScholarPubMed
64Romanow, RJ.Building on values: the future of health care in Canada-final report. National Library of Canada [Internet]. 2002 [cited 2009 Nov 27];8:171–86. Available from: publications.gc.caGoogle Scholar
65Hollander, MJ.Unfinished business: the case for chronic home care services, a policy paper. Victoria, BC: Hollander Analytical Services Ltd; 2003 [cited 2009 Nov 27]. Available from: www.ocsa.on.ca/userfiles/Hollander.pdfGoogle Scholar
66Chappell, N.Maintaining the integrity of home care. Healthcare Papers. 2000;1(4):91–5.CrossRefGoogle ScholarPubMed
67Markle-Reid, M, Browne, G, Weir, R, Gafni, A, Roberts, J, Henderson, S.Seniors at risk: the association between the six-month use of publicly funded home support services and quality of life and use of health services for older people. Can J Aging. 2008;27(2): 207–24.CrossRefGoogle ScholarPubMed
68Hall, R, O’Callaghan, C, Bayley, M, et al.Ontario stroke evaluation report 2010: Technical report. Toronto: Institute for Clinical Evaluative Sciences; 2010.Google Scholar
69Stroke Strategy Steering Committee, Heart and Stroke Foundation of Ontario. Stroke rehabilitation consensus panel report. Toronto, Ontario: Heart and Stroke Foundation of Ontario; 2000 [cited 2009 Nov 27]. Available from: http://profed.heartandstroke.caGoogle Scholar
70Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada. Ethical conduct for research involving humans. Ottawa, Ontario: Interagency Secretariat on Research Ethics; 1998 (with 2000, 2002 and 2005 amendments) [cited 2009 Nov 27]. Available from: www.pre.ethics.gc.caGoogle Scholar
71Moher, D, Schulz, KF, Altman, D, CONSORT Group. The CONSORT Statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001;285(15):1987–91.CrossRefGoogle Scholar
72Pfeiffer, E.A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433–41.CrossRefGoogle Scholar
73MacAdam, M.Home care: it’s time for a Canadian model. Healthe Pap. 2000;1(4):9–36.CrossRefGoogle ScholarPubMed
74Markle-Reid, M, Orridge, C, Weir, R, et al.The comparative effects and costs of a specialized interprofessional team approach to community-based stroke rehabilitation for stroke survivors and their caregivers using home care services. Final Research Report Submitted to the Canadian Institutes of Health Research. 2009: October.Google Scholar
75Rapp, CA.The strengths model: case management for people suffering from severe and persistent mental illness. New York: Oxford University Press; 1998.Google Scholar
76Saleebey, D.The strengths perspective in social work practice. 3rd ed. Toronto: Allyn and Bacon; 2002.Google Scholar
77Heart and Stroke Foundation of Canada, Canadian Stroke Network. Towards a Canadian stroke strategy concept paper. Ottawa: The Foundation; 2003.Google Scholar
78Ware, J E, Snow, KK, Kosinski, M, Gandek, B.SF-36 health survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Centre; 1993.Google Scholar
79Duncan, PW, Lai, SM, Bode, RK, Perera, S, DeRosa, J.Stroke Impact Scale-16: a brief assessment of physical function. Neurology. 2003;60(2):291–6.CrossRefGoogle ScholarPubMed
80Weinert, C, Brandt, P.Measuring social support with the Personal Resource Questionnaire. West J Nurs Res. 1987;9(4):589–602.CrossRefGoogle ScholarPubMed
81Radloff, LS.The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas. 1977;1: 385–401.CrossRefGoogle Scholar
82Kessler, RC, Andrews, G, Colpe, LJ, et al.Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.CrossRefGoogle ScholarPubMed
83Wood-Dauphinee, SL, Opzoomer, MA, Williams, JI, Marchand, B, Spitzer, WO.Assessment of global function: the Reintegration to Normal Living Index. Arch Phys Med Rehabil. 1988;69(8): 583–90.Google ScholarPubMed
84Browne, G, Gafni, A, Roberts, J.Approach to the measurement of resource use and costs. (Working Paper S06-01). Hamilton, Ontario: McMaster University, System-Linked Research Unit on Health and Social Service Utilization; 2006.Google Scholar
85Drummond, MF, O’Brien, B, Stoddart, GL, Torrance, GW.Methods for the economic evaluation of health care programmes. 2nd ed. Toronto: Oxford University Press; 1997.Google Scholar
86Browne, G, Roberts, J, Byrne, C, Gafni, A, Weir, R, Majumdar, B.The costs and effects of addressing the needs of vulnerable populations: results of 10 years of research. Can J Nurs Res. 2001;33(1):65–76.Google ScholarPubMed
87Browne, G, Roberts, J, Gafni, A, et al.Economic evaluations of community-based care: lessons from twelve studies in Ontario. J Eval Clin Pract. 1999;5(4):367–85.CrossRefGoogle ScholarPubMed
88Guerriere, DN, Ungar, WJ, Corey, M, et al.Evaluation of the ambulatory and home care record: agreement between selfreports and administrative data. Int J Technol Assess. 2006;22 (2):203–10.CrossRefGoogle ScholarPubMed
89Jorgensen, HS, Nakayama, H, Raaschou, HO, Olsen, TS.Stroke, neurologic and functional recovery the Copenhagen stroke study. Phys Med Rehabil Clin NA. 1999;10(4):887–906.CrossRefGoogle ScholarPubMed
90Horgan, NF, O’Regan, M, Cunningham, CJ, Finn, AM.Recovery after stroke: a 1-year profile. Disabil Rehabil. 2009;31(10):831–9.CrossRefGoogle ScholarPubMed
91Kelly-Hayes, M, Wolf, PA, Kase, CS, Gresham, GE, Kannel, WB, D’Agostino, RB.Time course of functional recovery after stroke: the Framingham study. J Neurol Rehabil. 1989;3(2):65–70.Google Scholar
92Forbes, DA, Stewart, N.Morgan, D, Anderson, M, Parent, K, Janzen, B.Individual determinants of home-care nursing and housework assistance. Can J Nurs Res. 2003;35(4):14–36.Google ScholarPubMed
93Markle-Reid, M, Browne, G, Gafni, A, et al.A cross-sectional study of the prevalence, correlates, and costs of falls in older home care clients “at risk” for falling. Can J Aging. 2010;29(1):119–37.CrossRefGoogle ScholarPubMed
94Speechley, M, Tinetti, M.Falls and injuries in frail and vigorous community elderly persons. J Am Geriatr Soc. 1991;39(1): 46–52.CrossRefGoogle ScholarPubMed
95Clarke, P, Marshall, V, Black, SE, Colantonio, A.Well-being after stroke in Canadian seniors: findings from the Canadian study of health and aging. Stroke. 2002;33(4):1016–21.CrossRefGoogle ScholarPubMed
96Wetherington, E, Kessler, R.Perceived support, received support, and adjustment to stressful life events. J Health Soc Behav. 1986;27 (1):78–89.CrossRefGoogle Scholar
97Kim, P, Warren, S, Madill, H, Hadley, M.Quality of life of stroke survivors. Qual Life Res. 1999;8(4):293–301.CrossRefGoogle ScholarPubMed
98Jönsson, AC, Lindgren, I, Hallström, B, Norrving, B, Lindgren, A.Determinants of quality of life in stroke survivors and their informal caregivers. Stroke. 2005;36(4):803–8.CrossRefGoogle ScholarPubMed
99Gilbody, S, House, AO, Sheldon, TA.Screening and case finding instruments for depression. Cochrane Database Syst Rev. 2005; (4):CD002792.Google ScholarPubMed
100Markle-Reid, M, Browne, G, Gafni, A, et al.The effects and costs of a multifactorial and interdisciplinary team approach to falls prevention for older home care clients “at risk” for falling: a randomized controlled trial. Can J Aging. 2010;29(1):139–61.CrossRefGoogle ScholarPubMed
101Barrett, JV, Curran, V, Glynn, L, Godwin, M.CHSRF synthesis: interprofessional collaboration and quality primary healthcare. Ottawa: Canadian Health Services Research Foundation; 2007 Dec [cited 2009 Nov 27]. Available from: www.chsrf.caGoogle Scholar
102Sommers, LS, Marton, KI, Barbaccia, JC, Randolph, J.Physician, nurse, and social worker collaboration in primary care for chronically ill seniors. Arch Intern Med. 2000;160(12):1825–33.CrossRefGoogle ScholarPubMed
103Callahan, CM, Boustani, MA, Unverzagt, FW, et al.Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA. 2006;295 (18):2148–57.CrossRefGoogle ScholarPubMed
104Gilbody, S, Bower, P, Fletcher, J, Richards, D, Sutton, AJ.Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166 (21):2314–21.CrossRefGoogle ScholarPubMed
105McAlister, FA, Lawson, FME, Teo, KK, Armstrong, PW.Asystematic review of randomized trials of disease management programs in heart failure. Am J Med. 2001;110(5):378–84.CrossRefGoogle Scholar
106Markle-Reid, M, Weir, R, Browne, G, Roberts, J, Gafni, A, Henderson, S.The effectiveness and efficiency of home-based nursing health promotion for older people: a review of the literature. Med Care Res Rev. 2006;63(5):531–69.CrossRefGoogle ScholarPubMed
107Williams, AP, Challis, D, Deber, R, et al.Balancing institutional and community-based care: why some older persons can age successfully at home while others require residential long-term care. Longwoods Rev. 2009;7(1):95–105.Google Scholar
108Markle-Reid, M, Weir, R, Browne, G, Roberts, J, Gafni, A, Henderson, S.Health promotion for frail older home care clients. J Adv Nurs. 2006;54(3):381–95.CrossRefGoogle ScholarPubMed
109Roderick, P, Low, J, Day, R, et al. (2001). Stroke rehabilitation after hospital discharge: a randomized trial comparing domicillary and day-hospital care. Age Ageing. 2001;30(4):303–10.CrossRefGoogle Scholar
110Brady, BK, McGahan, L, Skidmore, B.Systematic review of economic evidence on stroke rehabilitation services. Int J Tech Assess Health Care. 2005;21(1):15–21.CrossRefGoogle ScholarPubMed
111Anderson, C, Mhurchu, CN, Rubenach, S, Clark, M, Spencer, C, Winsor, A.Home or hospital for stroke rehabilitation? Results of a randomized controlled trial: II: cost minimization analysis at 6 months. Stroke. 2000;31(5):1032–7.CrossRefGoogle ScholarPubMed
112Beech, R, Rudd, A, Tilling, K, Wolfe, C.Economic consequences of early inpatient discharge to community-based rehabilitation for stroke in an inner-London teaching hospital. Stroke. 1999;30(4): 729–35.CrossRefGoogle Scholar
113von Koch, L, de Pedro-Cuesta, J, Kostulas, V, Almazán, J, Holmqvist, LW.Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost. Cerebrovasc Dis. 2001;12:131–8.CrossRefGoogle ScholarPubMed
114Sidani, S, Epstein, DR, Moritz, P.An alternative paradigm for clinical nursing research: an exemplar. Res Nurs Health. 2003;26(3): 244–55.CrossRefGoogle ScholarPubMed
115Neumann, PJ, Araki, SS, Gutterman, EM.The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J Am Geriatr Soc. 2000;48(12):1646–54.CrossRefGoogle ScholarPubMed