Nurse-initiated transitional care interventions to support the transition from hospital to home amongst older stroke survivors and caregivers: A systematic review and meta-analysis
- 1School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- 2School of Health and Life Sciences, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
Abstract
Objective: To explore and describe the components and underpinning theories of nurse-initiated transitional (hospital-to-home) care and to evaluate the effects of interventions on activities of daily living (ADLs), quality of life (QoL), depression, anxiety, self-efficacy, stroke-related knowledge, patient satisfaction and healthcare service utilisation in older stroke survivors and self-efficacy, caregiver burden, QoL and satisfaction with care in caregivers.
Data sources: MEDLINE, CINAHL, Cochrane Library, Health and Medical Collection, Nursing and Allied Health, Web of Science, Health Source: Nursing/Academic Edition and Scopus databases were searched in February 2024 and updated in March 2026.
Review methods: Randomised controlled trials (RCTs) and cluster-RCTs were included. Risk of bias was assessed using the Cochrane Risk of Bias tool, and evidence quality was rated with GRADE. Meta-analysis was undertaken using random-effects models.
Results: Seventeen trials were included. Transitional care interventions were guided by various theoretical frameworks and had multiple components. Interventions improved ADLs at 1 month (standardised mean difference (SMD) 0.54; 95% CI 0.12–0.97, four studies) and 3 months (SMD 0.43; 95% CI 0.12–0.74, seven studies), increased patient satisfaction and reduced hospital readmissions up to 3 months. Interventions may improve the Mental Component Score at 1 month, Role Limitations due to Physical Problems and General Health of QoL at 6 months. The certainty of evidence was low to very low.
Conclusion: Nurse-initiated transitional care can improve ADLs and QoL, while reducing hospital readmissions among older stroke survivors during the hospital-to-home transition. Multicomponent interventions combining home visits and follow-up phone calls may enhance improvements in ADLs. High-quality studies are needed to clarify long-term effects.
PROSPERO ID: CRD42024517619.
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BibTeX
@article{ankanawin2026nurseinitiated,
title = {{Nurse-initiated transitional care interventions to support the transition from hospital to home amongst older stroke survivors and caregivers: A systematic review and meta-analysis}},
author = {Usanee Ankanawin and Lisa Kidd and Dawn A Skelton},
journal = {Clinical Rehabilitation},
year = {2026},
month = jun,
doi = {10.1177/02692155261430092},
url = {https://doi.org/10.1177/02692155261430092},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Nurse-initiated transitional care interventions to support the transition from hospital to home amongst older stroke survivors and caregivers: A systematic review and meta-analysis
AU - Usanee Ankanawin
AU - Lisa Kidd
AU - Dawn A Skelton
PY - 2026
DA - 2026/06/10
JO - Clinical Rehabilitation
DO - 10.1177/02692155261430092
UR - https://doi.org/10.1177/02692155261430092
AB - Objective: To explore and describe the components and underpinning theories of nurse-initiated transitional (hospital-to-home) care and to evaluate the effects of interventions on activities of daily living (ADLs), quality of life (QoL), depression, anxiety, self-efficacy, stroke-related knowledge, patient satisfaction and healthcare service utilisation in older stroke survivors and self-efficacy, caregiver burden, QoL and satisfaction with care in caregivers. Data sources: MEDLINE, CINAHL, Cochrane Library, Health and Medical Collection, Nursing and Allied Health, Web of Science, Health Source: Nursing/Academic Edition and Scopus databases were searched in February 2024 and updated in March 2026. Review methods: Randomised controlled trials (RCTs) and cluster-RCTs were included. Risk of bias was assessed using the Cochrane Risk of Bias tool, and evidence quality was rated with GRADE. Meta-analysis was undertaken using random-effects models. Results: Seventeen trials were included. Transitional care interventions were guided by various theoretical frameworks and had multiple components. Interventions improved ADLs at 1 month (standardised mean difference (SMD) 0.54; 95% CI 0.12–0.97, four studies) and 3 months (SMD 0.43; 95% CI 0.12–0.74, seven studies), increased patient satisfaction and reduced hospital readmissions up to 3 months. Interventions may improve the Mental Component Score at 1 month, Role Limitations due to Physical Problems and General Health of QoL at 6 months. The certainty of evidence was low to very low. Conclusion: Nurse-initiated transitional care can improve ADLs and QoL, while reducing hospital readmissions among older stroke survivors during the hospital-to-home transition. Multicomponent interventions combining home visits and follow-up phone calls may enhance improvements in ADLs. High-quality studies are needed to clarify long-term effects. PROSPERO ID: CRD42024517619.
SN - 0269-2155
SN - 1477-0873
ER -