An m-health transitional care intervention delivered by nurses improves post-discharged outcomes of caregivers of patients with traumatic brain injury: A randomized controlled trial

Abstract

Introduction Caring for patients with traumatic brain injury (TBI) during the transition period from hospital to home can be psychological challenging to caregivers.

Aim To assess the effectiveness of a novel m-health transitional care intervention to reduce stress and burden of caregivers of patients with TBI and to reduce readmissions.

Methods A randomized controlled trial with 74 caregivers of adult patients with moderate or severe TBI admitted to a referral hospital in Indonesia. An m-health application for android mobile phones was designed including education and information for caregivers. The application included an online chat feature, with weekly monitoring. The m-health transitional care intervention also included face-to-face education before hospital discharge. Primary outcomes were caregivers’ stress and burden. Outcomes were measured at 3-time points; at hospital discharge (T0), two (T1) and four (T2) weeks post-discharge. Random Allocation Software was used to allocate study participants.

Results Final analysis included data of 37 caregivers in the intervention group and 37 in the control group. Stress within the intervention group decreased over time (p<0.001, MD = 11.05). Between both groups, stress was significantly different at T1 and T2 (p<0.001). The caregiver burden showed similar results (T1 p<0.001 and T2 p<0.001). Only one patient in the control group was readmitted to the hospital.

Conclusion The m-health transitional care intervention reduced stress and burden of caregivers of patients with moderate or severe TBI. Nurses should consider using m-health technologies to support caregivers from hospital into the community.