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

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.