Evaluating the Effect of Nurse-Led Stroke Transitional Care in Tanzania

NCT07319312 | Recruiting

• 2 other identifiers: Shandong@202572274110
• Study Type: observational
• Target: 130
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this observational study is to assess the effects of nurse-led stroke transitional care in stroke survivors, caregivers and healthcare providers who participate in nurse-led stroke transitional care program to improve discharge preparedness, disease self-management and quality of life among stroke survivors. The main question it aims to answer is: does nurse-led stroke transitional care program improve discharge preparedness, disease self-management and quality of life among stroke survivors? Participants are currently participating in nurse-led stroke transitional care program as part of their medical care. Stroke survivors and their caregivers will be followed for six months period to assess their transitional care quality and clinical outcome measures.

Conditions

Stroke Acute; Stroke (CVA) or Transient Ischemic Attack

Outcome Measures

Primary Outcomes (7)

• Self-efficacy among stroke survivors

  Ability to take control and perform recommended health behaviors and discharge instructions. Self-efficacy will be measured by the Stroke Self-Efficacy Questionnaire (a=0.9) developed by Jones and colleagues. This will be measured by a scale as total scores and mean scores. High total and mean scores indicate better ability to follow and adhere to healthy lifestyles after stroke

  6 months after discharge

• Quality of life among stroke survivors

  Quality of life that will be measured by the Stroke Specific Quality of Life (SSQoL) with (a=0.85). This will be measured by a scale as total scores and mean scores. High total and mean scores indicate better quality of life as evidenced by ability to perform self-care activities, improved cognitive function, mobility, and engaging in social activities

  6 months after discharge

• Discharge preparedness among survivors

  Discharge preparedness that will be measured by the Short Forms of the Readiness for Hospital Discharge Scale (RHDS) developed by Weiss. This will be measured by a scale as total scores and mean scores. High total and mean scores indicate readiness for hospital-to-home discharge among stroke survivors.

  within 1 month after discharge

• Discharge preparedness among health care providers

  Discharge preparedness that will be measured by the Short Forms of the Readiness for Hospital Discharge Scale (RHDS) developed by Weiss. This will be measured by a scale as total scores and mean scores. High total and mean scores indicate agreement on readiness for hospital-to-home discharge among nurses and doctors.

  within 1 month after discharge

• Resilience among caregivers

  Resilience will be measured by the 10-items Connor-Davidson Resilience Scale (CD-RISC) validated by Laura with a=0.85). This will be measured by a scale as total scores and mean scores. High total and mean scores indicate better ability and readiness to take care giving responsibilities.

  6 months after discharge

• Quality of transition care among survivors and caregivers

  Quality of TC will be measured by the Care Transitions Measure (CTM) Tool developed by Eric Coleman. This will be measured by a scale as total scores and mean scores. High total and mean scores indicate better perceived quality of transition care.

  within 1 month after discharge

• Caregiver self-efficacy

  Caregiver self-efficacy will be measured by the 10-items Family Caregiver Activation Tool (FCAT) developed by Coleman with a=0.6. This will be measured by a scale as total scores and mean scores. High total and mean scores indicate better ability to assist the stroke survivors to follow and adhere to healthy lifestyles and clinic appointment after stroke

  6 months after discharge

Secondary Outcomes (5)

• Depression and anxiety among survivors and caregivers

  6 months after discharge

• Care satisfaction among survivors and caregivers

  within 1 month after discharge

• Mortality among survivors

  6 months after discharge

• readmission among survivors

  6 months after discharge

• length of hospital stay among survivors

  Day 1 after discharge

Study Arms (1)

Historical control group

Stroke survivors and their caregivers received usual care

Behavioral: Nurse-led stroke transitional care program

Interventions

Nurse-led stroke transitional care program BEHAVIORAL

Participants in intervention group will receive usual care plus nurse-led stroke transitional care. Two nurse champions will conduct the face-to-face sessions while other two nurse researchers will conduct the telephone call sessions between August and December, 2025. During hospitalization, the two nurse champions will conduct five face-to-face sessions (2 individual sessions at admission; and at discharge), and three group sessions with 2-4 dyads of patients and caregivers. After hospitalization, two nurse researchers will conduct seven follow-up sessions for three months via phone calls at day 3, week 1, week 3, week 5, week 7, week 9, and week 11. The face-to-face sessions and phone call sessions will take 40-60 minutes and 20-30 minutes respectively

Historical control group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study will include nurses, doctors, stroke survivors and caregivers who are directly involved in hospital-to-home transition.

You may qualify if:

• Clinical nurses and physicians with six months of working experience in stroke care
• Clinical nurses and physicians with a minimum of diploma in their professions.
• Stroke survivors with 18 years old and above
• Stroke survivors admitted in the stroke units
• Stroke survivors with primary diagnosis of stroke confirmed by brain CT/MRI
• Stroke survivors who undergo usual discharge process
• Stroke survivors who live with their family caregivers
• Stroke survivors who have mobile phones
• Stroke survivors who can read and write
• Stroke survivors who are able to communicate
• Stroke survivors with National Institutes of Health Stroke Scale (NIHSS) \< 6
• Stroke survivors with Modified Barthel Index (MBI) \> 9
• Stroke survivors with Modified Rankin Scale (mRS) \< 5
• Stroke survivors with Montreal Cognitive Assessment Test (MoCA) \> 14
• Stroke survivors who are expected to stay in the ward for 3-5 days,

You may not qualify if:

• Healthcare providers who will be on leave during the study period.
• Stroke survivors with previous stroke who are not admitted in stroke units
• Stroke survivors who are discharged against medical advice
• Stroke survivors who have end-stage organ failure
• Stroke survivors who have family caregivers
• Stroke survivors who can't read/write
• Stroke survivors who have no mobile phones.
• Family caregivers without mobile phone that is accessible

Sponsors & Collaborators

• Shandong University: lead

Study Sites (1)

Muhimbili University of Health and Allied Sciences

Dar es Salaam, 65001, Tanzania

RECRUITING

MeSH Terms

Conditions

Stroke; Ischemic Attack, Transient

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Brain Ischemia

Central Study Contacts

Nyagwaswa Michael, Masters

CONTACT

+255685005923; nyagwaswamichael04@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 19, 2025
• First Posted: January 6, 2026
• Study Start: August 1, 2025
• Primary Completion: March 25, 2026
• Study Completion: March 30, 2026
• Last Updated: January 6, 2026

Record last verified: 2025-12

Locations

TA (1)