Design and Development of Risk Assessment Software for the Home Care of Older People with Stroke: Theory and Framework (Preprint)

BACKGROUND Adequate and timely risk assessment for stroke care is a key factor in effectively reducing acute complications of stroke. However, assessments are conducted only by health care professionals in the hospital, and it is difficult to continue assessments after discharge. Therefore, it is necessary to strengthen the risk assessment of post-discharge stroke care for older people at home, and innovative developments, such as the internet and virtual reality, have provided new ways of out-of-hospital assessment. OBJECTIVE In this study, risk assessment software is designed based on a hospital information management platform and mobile smart terminal to provide scientific care assessment and guidance to the community and families to reduce the occurrence of care risks. METHODS In this study, the International Classification of Functioning, Disability, and Health (ICF) theory, human-computer interaction theory, and situational learning theory were used as the theoretical framework of software design. Based on the results of the preliminary home care risk survey, the literature review method and Delphi expert consultation method were used to determine the assessment content framework. A multidisciplinary team of experts in neurology, rehabilitation medicine, geriatrics, sociology, psychology, computer science, etc., was formed to collaborate on constructing the assessment software operation framework. RESULTS We named the software "Stroke Home Guard (SHG)". The assessment content framework is based on four areas: body function and structure; activity participation; environment; and personal factors, including 19 care risk points (falls, pressure sores, aspiration, etc.). The operating system framework has two ports: the patient's mobile terminal and the medical and nursing terminal, including disease assessment, high-risk monitoring, online medical care, emergency assistance, and other modules. The core function is that the patient completes a condition assessment through the combination of self-assessment by the software and professional assessment by the medical and nursing terminal. By summarizing the assessment scores and classifying the warning risk level, this software can help us carry out preventive measures to avoid stroke risk. CONCLUSIONS The stroke home care risk assessment software adopts a multidisciplinary theoretical framework to make the assessment systematic and comprehensive, ensuring the timeliness and accuracy of the assessment while improving the safety of home care, meeting individualized care needs, and improving the level of community and family continuity of care.