The experience of stroke survivors and caregivers during hospital-to-home transitional care: A qualitative longitudinal study.

BACKGROUND: Stroke survivors and their caregivers experience different difficulties that arise from certain physical, psychological, social aspects and caring burdens during the hospital-to-home transitional period. Although there are abundant studies that focus on stroke transitional care, there are limited qualitative studies that synthesize the experience of hospital-to-home transitional care for stroke survivors and their caregivers in China. OBJECTIVE: To evaluate the experience of stroke survivors and their family caregivers during hospital-to-home transitional care in China. METHODS: A qualitative longitudinal study based on semi-structured interviews were implemented to address the research objective. Interviews were conducted at two stages, (1) when stroke survivors were close to discharge, and (2) within two months post-discharge. Participants were recruited from one tertiary hospital between April and September 2019. Data were analyzed using reflexive thematic analysis. FINDINGS: Twenty-three stroke survivor/caregiver dyads participated, totaling 92 individual interviews. The thematic framework based on the experience of stroke survivors and caregivers reveals a three-phases of the hospital-to-home trajectory: survived, living in the mist, and crisis at home. The study identified one key theme (the optimism and hope) in the first phase, four key themes in the second (the pre-discharge emotional concerns and reactions, lack of stroke knowledge and stroke care information, difficulties of performing home-based healthcare, expectation of hospital pre-discharge) and in the third phase (high level of post-discharge stress, inaccessible postdischarge care services and health resources, interpersonal relationship disruption and lifestyle changes, financial burdens) respectively. In addition, several interconnected subthemes for stroke survivors' and caregivers' experiences were identified in each phase. CONCLUSION: The experience of stroke survivors and caregivers during hospital-to-home transitional care is a dynamic process with enormous challenges in each phase. These findings have implications for policymakers and health care systems regarding developing an enabling environment that supports successful hospital-to-home transitional care. Collaboration with health care professionals, accessible rehabilitation services and follow-up support after discharge, and available community and social support are warranted to be integrated into transitional care to help stroke survivors and caregivers to facilitate their hospital-to-home trajectory.

Changes in axial length after orthokeratology lens treatment for myopia: a meta-analysis.

PURPOSE: Orthokeratology (OK) lens is a popular optical method to control myopia progression. This study aimed to assess the effect of OK lens on axial length change compared with glasses. METHODS: PubMed, Web of Science, and Embase were searched to retrieve the related articles. Then, the articles were selected according to predefined criteria. Standardized mean difference (SMD) and 95% confidence interval (CI) were selected as effect size for combining and analyzing the change in axial length. RESULTS: A total of 13 articles were included in the present study. Different models were selected according to the heterogeneity of each analysis. The axial length change in OKs group was significantly smaller than control group; SMD (95% CI) of change in axial length was - 0.857 (- 1.146, - 0.568), p < 0.001 at the end of 1 year and - 0.701 (- 1.675, 0.272), p < 0.001 at the end of 2 years or longer time. CONCLUSIONS: OK lens treatment appears more effective in slowing axial elongation than glasses during the early treatment of myopia in children.